A Recipe for Curbing Chaos: 5 Tips to Stay Cool in the Emergency Department by Muhammad Akbar Baig (guest writer)
I will never forget
the day when I learned the meaning of stress in the Emergency Department (ED). There
was a massive multi-vehicle road traffic accident and many patients were
brought in, pulling away most of the ED doctors and nurses on call, leaving the
rest of the ED at my disposal. I was focusing on a procedure to save a man with
a life-threateningly low blood pressure, when a nurse approached me with an electro-cardiogram
of a new patient. Even at a distance, I could see he was suffering from a
massive heart attack. And if anything worse couldn’t have happened, there was
an overhead page for another trauma patient.
I felt my blood pressure
rise and I said to myself, “I can’t do this anymore!”
What makes ED physicians not
only stay calm, but function at the height of their game in face of an
emergency? Some people may be a natural at this. But for those who are not, including
myself, I have learned that we can rise to the challenge, eventually surprising
ourselves. In order to be effective, you must learn above all to keep your head.
The lessons that I share below apply to any challenge, whether it’s a real
emergency or merely the stuff of daily living. Try to stay in control with the
following five tips that I frequently use, and trust me, they work quite well.
1. Start breathing the right way.
When the body is in fight or flight mode, it starts to hyperventilate.
Hyperventilation drops your carbon dioxide levels and makes you feel even worse.
Do not only take slow, deep breaths as we are often told to do, in fact focus
on longer, slower exhalations. Practice regularly and turn this into a habit.
2. Check your own pulse. I
was once told in residency, “When you get
to a crashing patient, the first pulse to check is your own.” That is
because when we face panic, we go into fight-or-flight mode forgetting our
ability of critical and executive thinking. Therefore, do not jump into a
situation if you are feeling as chaotic as your surroundings.
3. Stop panicking. When you
are in the position of a team leader, whether running a code or as a teacher
during medical rounds, everyone looks to you. If you will lose control, they
will follow suit. Yes, you may be terrified on the inside, but if you can appear
calm externally, your entire team will feel more capable.
4. Focus on what needs to be done
first and do it. The complexity of dealing with a crisis can paralyze
decision making. Following the example of how we prioritize the “A-B-Cs” in
emergency medicine, identify the priorities in respect to your patient and address
them first. Do not be tempted to get misguided in trying to figure out each and
everything from the start.
5. Always communicate clearly with
the team. Do not forget that your team can be a great source of
insight. When I am taking care of a particularly challenging case, I will often
stop and ask my team for any suggestions. Sometimes, a different point of view can
make all the difference.
Try the above and see for
yourself the changes that result. And always remember that you have the upper
hand in ED-based crises as long as you approach them methodically.
CREDITS:
About the Author: Dr. Muhammad Akbar Baig, is an Instructor, Dept. of Emergency Medicine, AKU.
Editorial Note: This is from a 'phase II' continuation of Narrative Medicine at AKU - what started as a Workshop-based initiative on January 20th, 2016. The editorial work was performed by the Writers’ Guild, an interest group at AKU, with the purpose to promote love of reflective reading and writing, within and outside of AKU.
DISCLAIMER: Copyright belongs to the author. This blog cannot be held responsible for events bearing overt resemblance to any actual occurrences.
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