Archives for September 30, 2006

ATLS Sillyness

I have to recertify my Merit Badge in ATLS next week, and have been reading the text in preparation.  This is because the test is over the book, not what’s actually done in ATLS, so you have to know what the book answer is, even though it may be 1-3 years behind current practice due to publication lag, etc.


Here’s the howler I found a few days ago, just by literally flipping open the book and starting to read:

Chapter 1: Assessment/Secondary Survey:


a. Inspect…

b. Auscultate for the presence or absence of bowel sounds

c. Percuss…

The average trauma room is as noisy as standing next to a city bus at idle on a busy street.  Often raising ones’ voice is necessary to be heard.  It’s not only not useful it’s entirely impractical.  The money is in the other exams, and I am amazed this got through.

More sillyness as I find it.


Oh, and I detest Merit Badge Medicine.  Both of my Professional Colleges have strong stands against the practice (ACEP and AAEM).  Nonetheless we do it ‘because we need it to keep our Level II Certification’.  So, it’s the surgeons’ fault I have to put up with this idiocy.

Update: I passed. I missed a question on the written though, so I’m a little bummed.

Cut to Cure cannot cut out the midlevel…

A nice, well-thought-out rant from Bard Parker:

Overextended…… I’m probably going to make some of my readers angry by posting this, but what the hell… First off let me say this is not an attack on physician extenders (NP’s, PA’s) whatsoever. I have a NP working with the trauma service and they are more helpful than the residents are. Some of the extenders are more capable than the physicians who supervise them. They also work in underserved areas delivering care to those who otherwise might not receive it. This is a beef I have with some physicians who utilize them, IMHO, in an unprofessional manner…

I don’t have much of this where I am, and consider myself fortunate for that. Read the post to understand what’s at stake.