One interesting aspect of the practice here: The EM registrars tend to call (or the nurses call for them) the ICU Registrar (and consultant) for every significant resuscitation. Unfortunately, those guys tend to arrive and take over - reinforcing my impression that EM here is 10-15 years behind the US in that EM is distinctly a second class specialty - a step removed from the GP's, and often treated as just overpaid interns (remember those days?). I've tried to discourage those early calls, unless we really need the help, and push the EM guys to do the resuscitation - both the diagnostic and cognitive parts of it, and the procedural stuff. Interesting how few procedures many of the guys have done, despite the large number of resuscitations we do (using the broad term resuscitation of trauma, sepsis, etc - not CPR stuff). There seem to be 2-5 folks per day needing serious attention to volume, airway management, arrhythmia treatment, etc.
On the other hand, it is fun to work with and/or watch these guys from ICU. Guess what - treating critically ill is all they do (we winnow out the chaff for them) and they are more practiced, experienced, and slick at it.
It makes me think that we really need to get one or more EM/Critical Care trained and (soon) boarded guys at DHEM/UCHSC. Someone of that ilk would be able to spend time in ICU working that end of the skill set, and share it with our residents - to the betterment of the training. Just a thought.
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