LERTS

Issue: BCMJ, vol. 55 , No. 7 , September 2013 , Pages 313 Editorials

When one arrives in a new country, the learning curve is steep. Though I came from an English-speaking country, much of the language in Canada was new to me. For example, in South Africa, drivers drive on the road (although that may be up for debate) and pedestrians walk on the pavement. Here, the words pavement and road are synonymous. South African cars have cubby holes, bonnets and boots, whereas Canadian cars have glove compartments, hoods, and trunks.

So it was no surprise to me that medical terminology would also re­quire some relearning. Many drugs have different names. Even acetaminophen is called something else (paracetamol) where I trained. I received help from the TV medical shows St. Elsewhere and Quincy, which ran on the then-primitive South African Broadcasting Corporation’s TV service in the 1980s. But I was not prepared for the rainbow of emergency codes that I had to learn for the first time, or the culture of training drills for those codes.

I was initiated into the hospital emergency code system and emergency drills soon after arriving in Canada. The local community hospital in Gladstone, Manitoba, was a 10-bed acute care facility attached to a medical clinic, laboratory, and X-ray facility. One morning, I was working away in the medical clinic, when over the intercom I heard the call: “Code Red, Ward 2, Code Red, Ward 2.” 

To me this meant a patient having a cardiac arrest (I obviously hadn’t paid too much attention to the TV medical dramas of the day). I dropped what I was doing and sprinted down the hallway connecting the clinic to the hospital. Instead of finding a patient in extremis, I ran into Ward 2 to find a fire drill in progress. The patient in the bed was a dummy (no, really). The hospital staff looked at me like I was taking the fire drill far too seriously. After realizing what was going on, I explained to them what I thought I was responding to. They all had a good chuckle at my expense (except the patient). 

Recently, a new code has crept into the lexicon in our health authority. While doing ward rounds a few weeks ago, I heard the following over the public address system of our hospital: “OCP Alert, OCP Alert.” It wasn’t a Code Red or a Code Blue, but it sounded important. After all, they don’t use the hospital PA system for trivial matters. I soon found out that this stood for “over capacity protocol.” This piqued my curiosity, so I had to ask what this was about.

Apparently, when a certain percentage of the stretchers in the emergency department are occupied by admitted patients, then the over-capacity protocol kicks into action. This includes the futile announcement over the PA system, followed by a fu­tile meeting of hospital management, followed by various futile at­tempts to create more beds in an already overcrowded hospital. People actually get paid to dream this stuff up and implement it. Do they think that we keep patients in hospital longer than is necessary or safe? Do they think that we are more likely to discharge patients when we hear that inane announcement? Maybe it is subliminal messaging. 

OCP Alert is as meaningless as an old piece of graffiti that I remember from my school days: BE A LERT; YOUR COUNTRY NEEDS LERTS
—DBC

David B. Chapman, MBChB. LERTS. BCMJ, Vol. 55, No. 7, September, 2013, Page(s) 313 - Editorials.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

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