I have to link again to Frank Drackman’s (highly R-rated) list of differences between surgeons and internists. Among them, “internists spend ten minutes securing a central line and it still falls out” – drove me crazy when I was sharing my patients with a MICU team. I didn’t want to say I could put a line in better than the medicine intern, but I sure knew I could sew it in tighter. (And anesthesiologists, Dr. Drackman, just don’t sew the arterial lines in at all, because by the time it falls out, the patient will be out of the OR; and because the surgeon is hounding them to start the case.) And “surgeon knows it’s an artery because it’s squirting across the room at 150mmHg;” yeah, I’ve seen my share of those. As long as the patient’s not hypotensive, there’s not much mistaking an arterial puncture or laceration.
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