CT Surgery Physician Assistants are the workhorses for most CT Surgery programs across the nation. There are dwindling numbers of experienced CT surgery Physician Assistants with the skill-sets required to effectively manage the high acuity patients. General Surgery residents are leaving CT Surgery in droves to maintain their strict 80 hour work week. CT Surgery PAs are leaving the jobs they love to pursue a better life in a less demanding specialty. There exists a shortage of CT Surgeons, and the problem will likely worsen. Hospitals are asking for more than ever from their CT Surgery physician assistants, putting their PAs at risk of burnout.
CT Assist Blog
Topics: Physician Assistant Burnout
Topics: Nailbed lacerations
Diffuse idiopathic skeletal hyperostosis (DISH) is an idiopathic disease characterized by osteophyte formation in the spine. Patience with DISH has confluent ossifications spanning 3 or more intervertebral disc spaces. This occurs most commonly in the thoracic and thoracolumbar spine. The bridging osteophytes follow the course of the anterior longitudinal ligaments and the peripheral disc margins. DISH primarily affects men more than women and occurs in those 60 years of age and older.
I remember when I first started working in the ICU, and I had to get my first patient off the ventilator. I thought, I have no idea how to do this. Luckily, in that case, I had an experienced ICU nurse who helped me. Getting the standard postoperative patient off the ventilator is now second nature, but I was recently talking to a newer colleague about how to do it, and I realized that a brief review might be helpful for any PA or NP new to the cardiac critical care setting.
Topics: Cardiac Surgery
Any mid-level practitioner who is responsible for running codes in the postoperative cardiac surgery population knows that there are a lot of moving parts in these scenarios. There are a lot of people to keep track of, and a lot of jobs to do in a short amount of time. Practice and experience keep mistakes to a minimum which, hopefully, produces a positive outcome. Unfortunately, I have been in several code situations where, even though we did everything right, there was still a less than favorable outcome. What I'm referring to are situations where ACLS guidelines have been applied, but have failed. For example, you pushed a milligram of epinephrine in a code, and your patient’s blood pressure went to three hundred mmHg, requiring a return to the operating room for bleeding. Perhaps your staff was doing appropriate CPR, hard and fast just like they teach it, and a saphenous vein graft was ripped off the heart, or an aortic suture line ruptured. I've even seen CPR cause a patient’s sternum to cut into his ventricle and cause catastrophic bleeding.
Your patient has made it out of the operating room, and you have succeeded in stabilizing him or her. Perhaps you were able to wean the patient from the ventilator quickly, or maybe the patient was in cardiogenic shock for weeks. Regardless of how the journey started the sign out is that your patient is now ready to transition to step down status, and it's your job to determine if he or she is ready.