Funtabulously Frivolous Friday Five 327

Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF, introducing the Funtabulously Frivolous Friday Five 327 – Halloween edition. For this special quiz we will deal with emergency superstitions (inspired by EMRAP September 2019)

Question 1

Does saying ‘I hope you have a quiet shift…‘ really impact the department?

Reveal the funtabulous answer

No…well, not in Japan.

Kuriyama et al conducted two parallel-group, assessor blinded, randomised trials at a tertiary ED in Western Japan. 25 resisdents recorded the number of patients they saw, the busyness and difficult of their shift on a 5-point Likert scale. One group received a peppy message from the attending such as “Hope you have a quiet day” while the other residents received no such words of encouragement.

There were no differences between the two groups concluding that “peppy comments from attending physicians had a minimal jinxing effect on the workload of resident working in the ED”.

Question 2

Are you the black cloud when it comes to patients on your shift and does it impact admission rates?

Reveal the funtabulous answer

Yes…well, sort of

Physicians often accuse their peers of being “black clouds” if they repeatedly have more than the average number of hospital admissions while on call or just huge number of complex or resuscitation cases.

A study done in 2004 by Walling discovered that ‘black’ clouds admitted 24% more patients. The residents would declare if they were a ‘white’ or a ‘black’ cloud and if they couldn’t decide the group would decide for them. Unfortunately I can’t pull the paper to see over what time period the residents were studied as our next paper will attest that over longer study periods, your ‘cloud predisposition’ is not fixed.

Ong et al in 2018 analysed 5 years of hospital admission data and found no difference in whether a physician was truly a ‘black’ or ‘white’ cloud. So like a kidney stone, this too shall pass. This is important to remember as Lake et al in 2017 found association with burnout and ‘black’ clouds so look after your residents who are having overly complex cases or busy shifts.


Question 3

Which of the following does a Full Moon affect?

ED volumes, dog bites, violent patients, MIs, Cardiac arrests, SAH, Kidney stones, Childbirth or road traffic crashes

Reveal the funtabulous answer

Only two of these are (possibly) true. Violence and Road traffic accidents

It seems globally the lunar cycle plays a large part in superstition across multiple cultures as there are multiple papers trying to find associations.

Thompson et al looked at 49 lunar cycles over 4 years and found no increase in ED admissions.

That said, at least in Australia, Calver et al found an increased likelihood of violent patents during a full moon:

Of 91 patients with violent and acute behavioural disturbance, 21 (23%) presented during the full moon–double the number for other lunar phases (P = 0.002). Sixty (66%) had either alcohol intoxication or psychostimulant toxicity, and five attacked staff (biting [2], spitting [1], kicking [1] and scratching [1]). In contrast, 512 hospital security calls for patients with less severe behaviour were evenly distributed throughout the lunar cycle.

Calver, 2009

And the other one which is true…road traffic accidents. Onozuka et al discovered there was an association with traffic accidents during a full moon, perhaps instead of looking at our phones while driving we peered up to take a look at the full moon!!


Question 4

Friday the 13th results in worse surgical outcomes, TRUE or FALSE?

Reveal the funtabulous answer


How about a 9 year study to settle the argument? Schuld et al looked at 27,914 surgeries evaluating blood loss, emergency frequency and intestinal perforations in patients undergoing general, visceral or vascular surgery. Not only did they look at Fridays landing on the 13th but also the phases of the moon and zodiac signs. None of these correlated with any statistical significance.


Question 5

Does the day you are discharged influence cause any adverse outcomes?

Reveal the funtabulous answer


In Japan, Taian (a lucky day) and Butsumetsu (an unlucky day) heavily correlate to day of discharge. Hira et al did a retrospective study on this phenomenon and showed that peak numbers of patients are discharged on Taian but the lowest on Butsumetsu.

These findings suggested that patients were extending their stay to leave hospital on a lucky day and thus increased the total cost of their stay. It was estimated in the study hospital this was costing an extra 7.4 million yen a year, creating a societal adverse outcome.


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Funtabulously Frivolous Friday Five

Dr Neil Long BMBS FACEM FRCEM FRCPC. Emergency Physician at Kelowna hospital, British Columbia. Loves the misery of alpine climbing and working in austere environments (namely tertiary trauma centres). Supporter of FOAMed, lifelong education and trying to find that elusive peak performance.

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