Abstract

his text is a real-time description of an emergency medi-cine resident’s shift in an overcrowded emergency de-partment (ED), Tehran, Iran. It is 3:35 pm of a warm af-ternoon; the emergency department is filled up with ill patients. Carrying in hand the file of a patient who had three episodes of convulsive seizure, you have to writing an order for another patient with suspected pulmonary embolism. Simultaneously, you are confronting with a pregnant woman complaining from loss of her baby’s movements and an addicted case with hangover feeling and low blood pressure. In addition, you have to provide a bed for the patient who is complaining from typical an-gina pectoris from the last night. When you decide to give the orders of the first patient to the nursing service, an intern informs you that another patient with ST segment elevation myocardial infarction has been presented.

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