r/emergencymedicine • u/Former_Bill_1126 ED Attending • Jul 20 '24
Advice US won’t come in if pain >12hrs
Working at a new site, US techs are very picky, will not come in for torsion studies if pain is >12hrs. I talked her into coming in and she’s pissed af, said she knows I’m new and “I’ll learn the protocol”.
Am I in the wrong?
Edit: Does anyone support the US tech or rad protocol and do you have any studies or evidence to support this practice? I’m just wondering if they pulled this out of their ass or where they got the arbitrary 12 hour thing?
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u/drag99 ED Attending Jul 20 '24 edited Jul 20 '24
Just lie and coach the patient to lie, as well, specifically with the tech (not the OB). Is anyone going to be harmed by you lying that pain has been present for 8 hrs instead of 18? Obviously not. Is the patient potentially going to be harmed by a nonsense protocol if you tell the truth? Decent chance. Doing no harm in EM sometimes means stretching the truth to get people to do their job (obviously this should only be utilized for situations where harm could come from telling the truth).
Another situation is telling an interventional cardiologist at 3am that a subtle STEMI patient has had pain for a few days (likely stuttering pain, but patients aren’t the greatest at explaining themselves). Just tell them “I dunno, a few hours” when asked. Saves a lot of headache, and potential harm to the patient.