Clerkship/residency tip #1: What to do if you drop your pager in the toilet

After teasing Anesthesiadoc about dropping her pager in the toilet (and then dropping my pager in the toilet the very next day), I've decided to share my guide to management of pager toilet immersions (PTIs).

1. As with most things in medicine, prevention is the name of the game. An informal survey of 18 medical students and residents found that 68% of PTIs occured when the user had clipped the pager to the waistband of his scrub pants, and a further 25% occurred when the pager had been placed in a rear pants pocket. 5% of those surveyed admitted to intentionally chucking the pager in the toilet. 2% of respondents were too embarrassed to admit how the PTI happened. Long story short? Keep your pager in a shirt or whitecoat pocket.

2. If the worst happens, there's what I call the golden minute of pager resuscitation. Most pagers are somewhat water-resistant, so the key is to get the pager out of the toilet as quickly as possible in order to minimize exposure. If at all possible, use universal precautions to minimize contact with body fluids.

3. Immediately remove the batteries.

4. Now comes the tough part: watchful waiting. As tempted as you are to put the battery back in and turn the pager on, you must wait for the pager to dry out. Sometimes this can take up to 3 days. Just trust me... don't try to speed up the process by using a hair dryer or microwave.

5. If all goes well, when you insert the batteries, the pager will come back to life. Don't pat yourself on the back yet... there's still one more step. Get some disinfectant wipes and scrub that baby down. Which brings us to an important tenet of intensive care medicine which can also be applied here. Some interventions are futile and would be inappropriate if offered. Use your clinical judgment when assessing the severity of a PTI. In some cases, it may be better to just cough up the $40 for a new pager.