Episode 16 - Pneumothorax - when less is more

Doctors from a small rural ED provide insights into their experiences of transfer conversations and this is juxtaposed with insights from 2 Emergency Physicians on the receiving side of those conversations.

Emergency Medicine is a practice that requires good procedural skills and clinical acumen but also good "soft" skills such as communication and team management but equally importantly self management. Dr Karen Coss, Director of Emergency Medicine at Tamworth Regional Referral Hospital in North Western NSW provides us with the insights she has learned through her reading and personal experience. 

Use of intercostal catheters and the management of pneumothoraces have been undergoing significant change over the last decade. The recent New England article comparing conservative management with interventional takes this the next station along the road.

• There are many stressful elements to working in the Emergency Department many of them often not related to the patient interaction. One that has to be well up there especially for people who hate confrontation is the “difficult consult”. You ring the inpatient team representative and are faced with obstruction/interrogation/disrespect/anger/sometimes downright bullying……. Dr Tucker is a highly experienced EP including at a departmental management level – so we explore some of his views on this issue and how to manage it.

Working as clinicians in the ED, especially in the one ED over time, it's easy to develop a fixed view on life and where you fit in "the system". This is a road to cynicism, pessimism and burn out for many people. Dr Anne Smith provides perspectives balanced by an international career, experience in multiple Australian  EDs and finally but not least from a woman's perspective in the world of Emergency Medicine.