ISPP 2015

Career Opportunities in Pharmacy
Day in the Life of a DOCTOR: DEADLY ALLERGY


Since childhood, I’ve always been a planner Organizing my days to be efficient and practical But as a doctor, your time isn’t your own and it can feel like you’re being pulled in a million directions phone calls, notes, medical emergencies, anaphylaxis, a code blue. Walking into the hospital in the morning, you have no idea what’s coming. Morning guys, I’m Siobhan, a second-year medical resident. I just got to the hospital. It’s actually a couple minutes after 7:00 so I’m kind of running a little late gotta hurry and um, I’m just meeting up with my staff physician and we’re going to be seeing the new patients that came into the emergency department overnight and get to know them. [violin music] In the morning, the resident or medical student who was on call last night tells the attending physician all about the patient they admitted, including their diagnosis and then their plan. This is the moment that a lot of us get feedback and teaching and as a medical student I actually found it nerve-wracking, but now this is an opportunity that I really value Ok, so it’s just about 8:00. Why don’t we just go and grab some coffee before we go to teaching? [Grace] That sounds great Ok, it’s my treat because you’ve done such an amazing job. Grace actually came in early to do a consult She’s an elective student. She’s – yeah. She’s doing an awesome job. It’s great to have her here [Grace] Thank you. Ok need sustenance Alright got a coffee or tea You got your coffee [Grace] Coffee! Perfect. Teaching time. This morning we did simulated scenarios focused on how to manage common emergencies we see in the hospital So now, it’s time to meet up with the poor exhausted resident who was on call overnight and hear about any issues that came up with their patients so that we can follow up with them during the day. Oh hey guys are you guys printing the lists? Yeah. Awesome. Ok, perfect. Hey um, how is the night? Oh, it’s pretty busy. Yeah, how many consults? Five. 5 consults seriously. Oh my gosh. How many do – you had to do 5 yourself? Yeah Shoot Ok, the team had like 20 Oh my gosh Something like that, yeah. You guys had a busy night. Yep Ok we’ll get a handover from you soon. so that you can head on home and get some rest. Yeah, I would appreciate that very much. [laughter] Next I assigned each medical student and resident specific patients to see and I always like to emphasize which patients actually need to be seen first So whether they’re the sickest or they’re actually doing well and they’re getting ready for discharge. So we’ve got two patients downstairs who are ready to go home One of them had a heart attack had a stent placed to open up their blood vessel And now was doing really well, ready to go home The other one came in confused and we’ve sort of fixed the underlying cause which were some electrolyte abnormalities because of a medication So I’m going to go downstairs to meet Jennifer, one of our excellent medical students, and she’s getting things set up So I’ll help go through it with her and sign off on the paperwork that she’s done [pager beeping] I got paged about a patient with a new rash. When I arrived to see her, she told me that her chest was feeling a bit tight and then talking to her nurse, I found out she was just receiving her first dose of an IV antibiotic. So we checked her vitals and luckily they were all normal but on physical exam I found her lungs were wheezy, and she had no history of asthma or lung disease, so it shouldn’t sound like that. I’m really concerned she’s having an allergic reaction to the medication. So immediately we stopped the antibiotic and we even took out the IV that it was running into Then we gave her some epinephrine (just like an EpiPen) and we gave her some benadryl and Bernadine and a steroid called solu-medrol. Then I ordered some bloodwork to rule out anything else that could be causing this. I was so relieved when her symptoms started to quickly resolve and her lungs no longer sounded wheezy. Okay, so the situation is resolved But I do want to call family and just update them and let them know what happened and that, um You know the patient is safe and okay, but I’m sure they’d like to see the family Okay, great. Okay. We’ll see you soon Okay, so um really lovely family so they’ve been updated Um, I’ve also got a text my um, my staff physician so that they’re way aware of what happened Um, I make sure that the chart- they know this is an allergy or what were thinking is an allergy and Um, I’m actually gonna move this patients to an obs bed, meaning an observation bed So they’re on closer surveillance and just make sure, um, that their breathing is okay moving forward and we can have attention very quickly if anything happens. So guys I really really want to stress how incredibly important it is to take allergies seriously So I actually grew up with a deathly allergy to milk products and I was fortunate enough that I grew out of it Um, but I used to carry around Epi-pens, but I never wanted to and I parents had to get on me so I just want to say if you have an allergy it is so important to carry it and If you need to use it you use it and you don’t carry around ones that are expired. All of this is critical so Um, yeah, I- I really can’t stress it enough especially when you see someone as sick as this patient was So I just finished up lunch and noon-hour teaching and now I’m heading down to the I guess health and wellness center here and the reason is because I need to get a TB screening test done Um, basically, I have to go on away electives, meaning I go to a different university, a different hospital and I do an elective in an area that I think I may want to pursue a subspecialty in and so I’m gonna be doing rheumatology at a different hospital and they require the TB screen testing So maybe I can show you guys what that’s like. I dunno, have any of you guys had one of those done before? The TB skin test is an intradermal injection So fluid with some purified protein from the bacteria is injected under the skin and it actually raises up like a wheel Then you come back in two to three days to have it read as positive or negative But the good news is that TB is actually curable So the important thing is just finding it if you’re positive so that you can get treatment. [pager beeping] [footsteps] Okay, so just finished up with that code blue Um, turned out it was a patient who was having a seizure So we gave, um, a fair a bit of Ativan stopped the seizure and then sent off a bunch of blood work just to make sure we know the cause. I think in the end this actually, um, was probably due to alcohol withdrawal Um, but we’re gonna just do a full workup or actually the- the team looking after this patient is gonna do a full workup because I was just there, um as sort of the- the code blue, uh, captain, uh, today Um, yeah. So anyway, I guess I get to just go on with my day seeing our patients at this point. Heading to meet the team now to review all the patients that everyone saw during the day I’ve seen most of them so I’ll have my opinion we can see if there are teaching points or, um If we all have the same opinion, I don’t know, that usually doesn’t happen [laughter] It’s almost 6 p.m. I’m having a little bit of a snack I’m on bridge so that I’m bridging the day and the night which means I now have to go down to the emergency department into a consult before I can go home so off I go Just finished the day ended up being actually a pretty simple consult patient came in with a really really high blood pressure and high sugars because Um, the patient had stopped taking their medication for the past year. And so, um we just need to get started back on them so Don’t forget to subscribe if you want to see more videos like this. Check out these videos if you want to see more in the hospital on call Um, and otherwise, I’ll be chatting with you guys next week. So bye for now

100 thoughts on “Day in the Life of a DOCTOR: DEADLY ALLERGY

  1. I have a mild allergy to walnuts and pecans. I grew out of my peanut allergy. I don’t carry around a EpiPen because I only get a few hives and my mouth feels a little weird is all.

  2. I'm TB positive. I have to get chest X-rays every 3 years. Nobody ever tells me the results:( what kind of X-ray do they do?

  3. Dr. Siobhan, I understand how antihistamines work. How does epinephrine respond to an allergy in the body?

  4. This is my Greys anatomy dream come true, real life Greys anatomy I love your videos 😍😊😍😊

  5. Hi!! I love you videos sooo much they are so fun.. could you maybe make a video where you explain the different positions in the medical field.. 🤪♥️♥️

  6. I love your videos, it might just be me but your voice is rly calming and whenever I have panick attacks to calm myself down I listen to your videos ❤️❤️❤️❤️💋

  7. Hi so i’m wondering if you ever work in any form of mental health? Or if you know any channels that do work in mental health hospital? I’m really interested on what’s it like to help mentally ill patients

  8. I want to be a doctor soo bad I’m going to school for it now wish me luck 🤞🏾🤞🏾🤞🏾🤞🏾

  9. Preach it sister I am allergic to peanuts treenuts fish shellfish milk and egg so epipens all the way

  10. I just want to say that you are a very caring and loving person who knows what you are doing and all that I can say is keep up the good work you are awesome.

  11. Do you have any suggestions of a channel that does gynecology residences explained like this!!! I want to be a gyno but want to learn

  12. I am really happy to see so many women in resident positions. Either they have amazing recruiters or the tides are changing now that men are free to become nurses without much fuss and women are encouraged to become doctors. Either that or they have women work with women but this is Canada not Iran

  13. As far as the epipen thing goes our care givers dont even have em half the time due to shortages or at least a while ago that was the case. Also without insurance in the USA you have to choose between paying rent or mortgage that month and remaining indoors or being homeless and having a new epipen…$700 for a single use product is insane and should have never been allowed to happen. I feel allowing people to draw and inject their own bolus of epi is a better solution than people going without. Epi is hardly expensive its the damn pen

  14. You're so right. My friend passed away because she was careless about keeping her EpiPen around. She was home alone, started having an attack, and couldn't find it. PEOPLE, KEEP HOLD OF YOUR MEDICINE, ALLERGIES DO KILL.

  15. I have to take a tb plant test because im in a nursing school and before I go out on co op I need to be tested for it obviously lol. If it comes back positive will I have to take a chest x-Ray to be sure that I don’t have it?

  16. This video is kinda old so I don't know if you'll reply to my comment but I have P.O.T.S. so epipens are pretty much deadly to me. My cousin has P.O.T.S. too and she was once given an epipen and it was rly bad. You probably haven't heard of P.O.T.S., but the awareness of it is getting better! Do you know if there's some alternative options for allergies?

  17. Last year I was really sick and I was severely allergic to the medicine they gave me called vancomycin and all they did was give me benadryl. I'm wondering why they didnt give me all the rest of the medicine that you gave that patient? Is it based on how bad the reaction is or the type of medicine that caused it maybe?

  18. I have a deadly allergy to nuts. Especially peanuts, almonds, and cashews. The allergy is so bad it’s off the charts! When I went to the doctor once he said it was the worst allergy he’s ever seen! It is crucial to carry around an epi pen. My mom lets me practice on old expired fruits with my expired epi. I’ve never had to inject myself and I am so glad! I have horrible anxiety towards my allergy. Thank you for putting that out! I know just how you felt! 💚

  19. Im growing out of an allergy that starts in the fall but ever since my family moved it's been getting a lot better

  20. Im deathly allergic to dairy and I hope I grow out of it because I have to carry around an epi pen and its annoying because if you loose it then it's hundreds of dollars out the drain. Also, watching all my friends eating whatever they want, it's kinda disappointing.

  21. I was wondering accept for other staff members i see an empty hospital. Any legal worries with other penitens ?

  22. Thank you for saying how allergies should be taken seriously. Every time I say I have severe allergy to dust and pollen people don't take me seriously, but when I start having problems breathing everyone goes nuts because they don't know what to do 🤦‍♀️
    I like your videos, give everyone a different view of the life of medical professionals ❤️

  23. I have really rare allergies called cold induced urticaria wich means i am allergic to cold water and the cold weather i also have skin righting so i can wright in my skin with my nail then it will come out in hives i also have ketotic hypo glysimia wich means my blood shuger gose low and keytones go high i have aslma wich is the only normal thing i have 😂😂😂 i take a lot of medicine a day.

  24. You remind me of dr manning on Chicago med she plays the violin and is a doctor and you look like her too

  25. Wow! That talk about allergies is really good! I’m allergic to a bunch of things and only 10. I don’t like carrying around my epipen everywhere and my mom does get on to me about that but I know I should. Thank you so much for that talk!

  26. i have bad allergies to basically the outside and my skin color is porcelain my meds say i cant be in the heat so what do i do?

  27. I don't have epi pens but I take benadryl if I have something with honey or something else I'm allergic to, bee stings though I'm not so sure~Silver

  28. I really like for you to make a video about what happens next after you finish your residency please. Explain all the options you have afterwards please.

  29. When I went to summer camp as a kid they made us do TB test before we went to camp. Mine came back negative

  30. I believe that I'm allergic to fish like tuna or salmon, but not shrimp or the like.
    When I eat tuna or salmon, I feel like I have swallowed a whole walnut with the shell on.

    Also, I do the blood TB test. I prefer it, honestly.

  31. I’m allergic to eggs and I used to be able to eat foods that had eggs in it but I was never able to eat actual eggs. My allergy actually deteriorated, so I can’t eat ANYTHING with eggs

  32. I really appreciate that you are always smiling even when times get tough because you have such a hard and manic job and i know it really helps when your not feeling great to see someone smiling and just doing something so simple really helps

    Xxx

  33. I love your videos! I’m a pharmacy Technician so it’s really awesome to see how a doctor’s day is before the pharmacy sees the patients that you discharge, etc.
    And it’s nice seeing a YouTube where I know the medical terms and medications you’re talking about lol.

  34. I don’t know how I found you but I’m obsessed !!!! You’re awesome and I think your chose the best field to work in!! You’re so kind and I can tell you’re good at what you do

  35. Something to add to your “forever learning list”, how to treat a patient who suffers an allergic reaction, possibly even anaphylactic shock, when they are a patient who has been diagnosed with the rare disease of Carcinoid Syndrome/Neuroendocrine Cancer, who is also diabetic due to the palliative somostatin LAR monthly treatment they receive. .That is me in a nutshell. Epinephrine can cause patients like me to go into Carcinoid Crisis which can be deadly, but so can anaphylactic shock without epinephrine and steroids. Steroids of course raise the glucose levels. It is believed to be the cause of me receiving last rights (I am Catholic) and ending up as a critical care patient, after going into anaphylactic shock after a cafeteria worker used a spoon from a shrimp dish to serve me my meal (this happened prior to my cancer diagnosis). Unfortunately, I was diagnosed at an advanced stage and am unknown primary – I also have a ton of allergies, quite a lot that lead to anaphylactic shock. Having an allergic reaction to a bee bite, fish, etc. now to me is more scary than my advanced cancer diagnosis is. Don’t be surprised if you see experts at odds on treating a patient like me, Carcinoid Syndrome treatment is still a work in progress, but unfortunately on the upswing. #Steve Jobs, Aretha Franklin, Dave Thomas all had a form of Neuroendocrine Cancer.

  36. Love to see how you bring the positive vibe naturally to all people around.. Hope you can share on how to manage stress and be positive

  37. I have always been a planner and organizer and list-maker, and what you said her really spoke to me. The past few years I've been feeling that I've been somehow failing at organizing and planning…but, as you said, my time is not my own. I teach full time in a public high school (English), and I am working on my doctorate, I have 2 teens (one just graduated h.s., one will next year), a household and husband… MY TIME IS NOT MY OWN, and so, as you described, I feel pulled so many different directions. Thank you for putting into words an explanation that makes sense.

  38. 5:00 need to show this part to my parents… they never believe me when I get an allergic reaction from cross contamination with fish :/

  39. Hi Violin Doctor:

    be careful when you shoot the video inside the hospital because it may violate the HIPPA and your hospital social media policy the lead you to loose your job and your MD license even your career!

    And it is NOT acceptable to hold the camera when you run to a code blue or share your shift report and your patient information in front of the camera and post on YouTube ! In addition to violating HIPPA, holding a camera will distract you from your patients and your clinical tasks! Remember: you are a Doctor facing the vulnerable lives but the actress facing the eye-grabbing cameras!

    Meanwhile, You put yourself, your patients, your co- workers, your leaderships as well as your hospital in a vulnerable position by shooting and publishing the real world videos! They suppose to stop this violating behavior right away as our patient advocates! As a professional Doctor, You need to focus on your patients but the camera during your work ! These sharing probably make a lot fun for your audiences but NO FUN at all for a medial professional and any Heath organizations !! !

    As a professional RN with 22years clinical experiences and patient advocate, I urge you to delete all your work related videos ASAP and stop violating our patient rights by shooting videos during your work! I will keep checking your channel and make official report to your licenses board as well as YouTube media platform if you won’t take my advices seriously ! 09/13/2019 5:44pm

  40. what kind of doors do you not have access to? like having that card, do you have access to all doors or is it limited?
    also nice videos, keep up the great work, you’re really entertaining!
    (I noticed the music that you and thatdenverguy use is the same)

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