Imagine Jeopardy theme music playing now ..........
Scroll down for answer once song is over. No sooner.
From most to least likely:
- Winning a prize (at least $3) with your next Powerball ticket: 1:36
- Seroconverting after being stuck with an 18 g angiocath used in an HIV positive patient: 1:300
- Diagnosing a deadly aortic dissection on your next shift: 1:1000*
- Being struck by lightening during your life time: 1:244,000
- Not just winning a prize, but THE GRAND Powerball prize, on your next ticket: 1:146,107,962
- Diagnosing a deadly aortic dissection three shifts in a row: 1:1,000,000,000. If you do this. Quit your job and play the lottery.
* This number needed some abstraction on my part. Here goes ... Mortality from aortic dissection is about 2.5 per 100,000 persons per year (Rosen's). There are 300 million persons in the United States. That means that in any given year, there are about 7,500 mortal aortic dissections.
There are about 32,000 US ED physicians . Assuming, the dissections are equally distributed among them, each ED physician sees 0.23 dissections per year or 0.001 dissections per shift (assuming 18 shifts/month x 12 months).
If this number is right, the average ED physician will see a dissection once every 4.6 years ... which seems about right and passes the gut check test.
Source
Ankel, F MD. "Aortic Dissection." Marx: Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed.
Bartlett, J. MD. and Weber, D. MD MPH. "Management of health care workers exposed to HIV." Up to Date. 30 September 2008.
"Powerball Odds." Durango Bill's Applied Mathematics. http://www.durangobill.com/PowerballOdds.html
"Your Real Odds of Getting Struck by Lightning" Ezine articles. http://ezinearticles.com/?Your-Real-Odds-of-Getting-Struck-By-Lightning&id=295290