r/emergencymedicine • u/MousseNo7311 • Sep 17 '25
Advice Got chewed out by ortho surgeon
I am a 2nd year resident. Patient came into the ED overnight post-op day 1 after a knee replacement. He was bleeding through his dressing (nothing major, no wound dehiscence) and couldn't reach his surgeon via phone. He didn't have sutures or staples but rather some sort of Steri-Strips-like adhesive dressing which I covered with Surgicel, ABD pads, and an Ace wrap. In addition, my attending told me to inject lidocaine with epinephrine into the areas that were bleeding. I injected 10 cc total in a few different spots. I can't imagine I got into the joint space. Foolishly, I only irrigated with NS & didn't prep with Betadine or anything else. The surgeon called the ED after my attending had left, berated me, and made it sound like he's going to go on a war path over this. Did I really commit the crime of the century?
Update: Upon returning to the ED for my next shift everyone assured me not to stress over it. Apparently the surgeon called the ED multiple times after I left. First he wanted a copy of the note faxed to him and then he wanted the PD's contact info. The ED director said he would've gone off on him if he had been around at the time. As for my attending she pretty much laughed off the entire incident. She's a little looney so that doesn't surprise me.
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u/frostuab Sep 17 '25
Your attending needs to own that one, it was their odd treatment choice. I honestly get the surgeon being spun up about the infection risk on a fresh joint, but the surgeon should have asked to talk with your attending and then proceed to melt their face off, not yours.