https://paulnystrom.com/tags/on-call/Recent content in On Call on Paul NystromHugoen-usWed, 25 Mar 2026 00:00:00 +0000https://paulnystrom.com/posts/distress-vs.-disaster/Wed, 25 Mar 2026 00:00:00 +0000https://paulnystrom.com/posts/distress-vs.-disaster/<p>There are two thresholds when it comes to medical complaints in the ER: distress and disaster.</p> <p>The distress threshold is the point at which patients decide to come to the ER. Whatever is bothering them, they feel it needs medical attention right away.</p> <p>The disaster threshold is the point at which a patient requires an immediate procedure, specific treatment, medicine, hospital admission, surgery, or specialist intervention.</p> <p>We in the ER live in the middle.</p>https://paulnystrom.com/posts/my-neurosurgeon/Sat, 10 Jan 2026 00:00:00 +0000https://paulnystrom.com/posts/my-neurosurgeon/<p>I was doing a ride-along with a friend of mine who works for a suburban police department. It was a call for an elderly lady with back pain. We were the closest unit and arrived before EMS did.</p> <p>The patient was about 80 years old, lying in her bed fully dressed, simply waiting for the ambulance. She had a history of prior back surgeries and reported that she had “broken rods” in her back. She was scheduled to have another surgery in a couple of months. She had a back brace and her rolling walker at the bedside. She was very calm and reasonable. She did not have any pain at rest, but she said it hurt too much to move, so that’s why she wanted to go to the hospital. There was no report of any new trauma.</p>