January Panel - Real Stories - Oops, patient is in V-tach. Admit your mistakes.

Practical EMS

Jumping back into failures in emergency medicine

Doug, ER physician, discusses how he missed a traumatic intraabdominal injury and an ectopic pregnancy. It’s easier in hindsight to see the things we could have done better. Admitting you screwed up can be difficult.

Leave work at work as much as possible

Nate talks about a patient that was initially written off as flu like symptoms, with no initial vitals being obtained that end up being in V-tach.

Anchoring bias is a big problem. Overcome your bias or you will miss something.

Doug, ER physician: The waters of emergency medicine are deep. You may be walking around in shallow water and then suddenly end up over your head.

Objective reports are much more helpful than biased ones

Nate, EMT: What’s the worst-case thing that could be going on with your patient? Start with the worst differential and work your way backwards.

Sarah, ER Nurse: We all strive for excellence, no one wants to miss something, but we are all capable of it. Hopefully we learn from the mistakes.

She tells a story of working a presumed cardiac arrest before checking a pulse.

She talks about a time where another nurse had to step in for her and advocate for a patient and she learned a tough lesson that she needs to be the one that steps up, no matter how uncomfortable and advocate for her patient.

Nate messes up an IO but initially didn’t want to admit his mistake.

FAIL STANDS FOR FIRST ATTEMPT IS LEARNING

Doug, ER physician: You must be able to move past a failure or this job isn’t for you. Things don’t always go right. If you haven’t failed yet, you will.

Casey, paramedic: You’re going to make mistakes. The culture is changing to make it easier to discuss mistakes with preceptors rather than be ridiculed.

HAVE EXTREME OWNERSHIP OVER YOUR FAILURES

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

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