All-Star Chief Complaints

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SuziQ

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is there a thread of funny ED CC's anywhere in the EM forum?

I have had heard some real winners in the past few days.. I think my favorite was:

"Earache- pain is 6/10- ear only hurts when I stick my finger in it" ummm?

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The chief complaint of a recent patient written by the triage nurse simply stated "Attacked by Crows". I had to look at it 3 times before believing it.
 
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The chief complaint of a recent patient written by the triage nurse simply stated "Attacked by Crows". I had to look at it 3 times before believing it.
I take it you did not grow up on a farm? Crows are nasty birds and rather territorial. While they don't normally attack people, one of my high school classmates ended up getting numerous small lacerations and contusions when he tried to get a small flock of crows out of a silo where they were eating the contents.
 
My favorites are:

CC: "Personal", "Problems down there", and "Pocket Rocket"

The first two ended up with Rocephin/Azithro/Flagyl, the last in the OR!
 
"I think I have gram negative sepsis."

I rolled my eyes... but it turned out she was right. Dropped her pressure about 3 hours after arrival, and went to the OR to have her infected port out.
 
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"blue vaginal d/c with fever".....
probably shouldn't use frozen blueberries as a lubricant.....
 
Another good one this week was:

"I was smoking crack with this guy I didn't know in his car, and when I told him I didn't want to pay him for it, he threw me out of the car and ran over my arm."

We also had a hysterical guy brought in by the police, actively threatening to kill his "woman" either by lighting her on fire or beating her with a baseball bat...that definitely wasn't funny, but the "nurse objective: pt appears angry" was very insightful.
 
CC: Can't hold breath
Schitzo frequent flyer who actually turned out to have active TB
 
CC: sudoseizures
 
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CC: blood pressure medication refill & would like to be counseled about weight loss. :rolleyes:
 
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"I think I have malaria" (he was right)

"Swallowed vibrator" ("swallowed" up the wrong end-He said "I hiccuped and it was gone" It had fresh batteries and was still vibrating on arrival).

"Recheck generalized weakness."

"Fibromyalgia attack"

"Recheck GSW"

or the combo chief complaints:

HA/ ? preg

Chest Pain/ vag D/C

Blurry vision/ diarrhea
 
Status post samurai sword

S/p plane crash into house

"no proprioception"
 
"Fibromyalgia attack"


Ah, the dreaded acute fibromyalgia attack.

This is usually complicated by >5 allergies to drugs that could be helpful and no one else is allergic to.

and associated axis II disorders

and a family that does not pay enough attention to them

and an unwillingness to listen to helpful information/question anything you might tell them because fibromyalgia pain is "different"
 
Chronic, see my post in the fibromyalgia thread about the 18 yo FM patient at 3am in the ED one night.
http://forums.studentdoctor.net/showthread.php?t=60862
My brain still hurts from that encounter.

Ah, the dreaded acute fibromyalgia attack.

This is usually complicated by >5 allergies to drugs that could be helpful and no one else is allergic to.

and associated axis II disorders

and a family that does not pay enough attention to them

and an unwillingness to listen to helpful information/question anything you might tell them because fibromyalgia pain is "different"
 
S/p plane crash into house

Sounds like something that would qualify someone for my research project! :laugh:
 
Chronic, see my post in the fibromyalgia thread about the 18 yo FM patient at 3am in the ED one night.
http://forums.studentdoctor.net/showthread.php?t=60862
My brain still hurts from that encounter.

In her case, since nothing else works, a little everclear prn should do the trick. Have the pharm tech stick it in an Rx bottle for ya

300px-EverclearHiRes.jpg
 
Chronic, see my post in the fibromyalgia thread about the 18 yo FM patient at 3am in the ED one night.
http://forums.studentdoctor.net/showthread.php?t=60862
My brain still hurts from that encounter.

I had seen it and in fact I posted earlier on in that thread.

It is amusing at times to talk with some of the folks who carry a dx of fibromyalgia or other such disorders.

I listen to them and think to myself maybe I have it. After a 10 hour case (not to mention 2 other shorter cases) bent over someone elses back and wearing a lead apron all day I am fatigued, my muscles are sore and ache and my feet kill me. When I get home all I want to do is sit on the couch and when I get up my feet hurt so bad I have trouble walking.

When I go and get a massage they tell me how tight all of my muscles are and about all the knots. I have counted and I have at least 15+ trigger points in my shoulders and upper back alone.

Oh wait, I take some ibuprofen, do my chores, go to sleep and wake up again and go back to work!

Sorry, I'm grumpy.

I had to deal with one of these folks today (FMS patient) as well as a spouse with Munchausens by proxy.

Her husband had a large disc herniation that was causing leg weakness. We got that out and his strength is better and he told the nurse his pain was a 1/10. We are talking to him and the wife reminds him to tell us that he is in horrible pain and can't walk right. His ambulation is fine.

Same lady who called the patient advocate without ever speaking to the patients nurse of the charge nurse because we had not checked on him the night he had surgery or early the next morning and she assumed that we would.

When we asked her if we had ever told her we would be by at those times she replied. "No, I just assumed you would".

Same lady who wanted me to prescribe Trazadone (asked for it by name) to help her husband sleep, this was pre-op.

I told her that once the herniation was gone that he would probably sleep like a baby and would most likely not need it. I was told that I needed to be more sensitive and "treat the whole patient".

I ordered Ambien and was reprimanded by her because it causes blood clots!

Arrghh!!!!!!!

Sorry for going OT, just had to rant.
 
CC: My dog ate my toe.

60 something yr old man with pretty bad pvd. Fell asleep in his Barcalounger and was awakend by Fido chomping on one of his toes. Fido actually disarticulated it at the MTP joint and had swallowed it before the guy could get it from him (like it mattered).

Funny thing was that he really didn't mind, it didn't hurt much AND Fido did it before on the other foot (he quickly pulled his stiff sock off to show us)!!

kg
 
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That dog likes free-toes!
 
Our computer system has a character limit on CC"s so that leads to some interesting ones such as:

HA PT has brain (that gives her a one up on mist people)
 
Ah, the dreaded acute fibromyalgia attack.

This is usually complicated by >5 allergies to drugs that could be helpful and no one else is allergic to.

and associated axis II disorders

and a family that does not pay enough attention to them

and an unwillingness to listen to helpful information/question anything you might tell them because fibromyalgia pain is "different"

I'm sure I've posted this before but I have a surefire Axis II diagnostic method based on the allergy list. If your patient has:
1. Allergies to >5 meds
or
2. Allergies to 3+ categories of meds
or
3. Allergies to 3+ pain meds (and it's never one that starts w/ D)

Your patient has a 99% chance of having an axis II disorder. I only say 99% b/c my n is only in the high double digits on this one (although it's 100% sensitive in my sample set) so I'm sure there really are non-crazy people (OK, maybe one person) w/ real allergies to that many meds but I've yet to meet them.
 
I'm sure I've posted this before but I have a surefire Axis II diagnostic method based on the allergy list. If your patient has:
1. Allergies to >5 meds
or
2. Allergies to 3+ categories of meds
or
3. Allergies to 3+ pain meds (and it's never one that starts w/ D)

Your patient has a 99% chance of having an axis II disorder. I only say 99% b/c my n is only in the high double digits on this one (although it's 100% sensitive in my sample set) so I'm sure there really are non-crazy people (OK, maybe one person) w/ real allergies to that many meds but I've yet to meet them.
That would make for a very interesting poster presentation at a conference. Sadly, I doubt it would ever get off the ground.


I remembered another classic CC from my days as an RT:
Patient (at the very top of their lungs, so loudly that they were heard OUTSIDE OF THE ED by the medics in the ambulance bay): "WHY AM I HERE? BECAUSE IF CAN'T ****ING BREATHE!"

:rolleyes:
 
In her case, since nothing else works, a little everclear prn should do the trick. Have the pharm tech stick it in an Rx bottle for ya

300px-EverclearHiRes.jpg

Honest to god, at my last hospital you could order beer (budweiser), rum, vodka, gin, or bourbon for each patient. Anything but beer they would send up in a 240mL bottle from the pharm. Nurses would measure out a little shot of it, put it on their tray, and walk away. I was always tempted to ask them to just pour a line of them.
 
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"d/c after oral Sx"

It was actually a patient who had discharge after oral surgery, but curiosity prevented that patient from sitting on the board for long.
 
Honest to god, at my last hospital you could order beer (budweiser), rum, vodka, gin, or bourbon for each patient. Anything but beer they would send up in a 240mL bottle from the pharm. Nurses would measure out a little shot of it, put it on their tray, and walk away. I was always tempted to ask them to just pour a line of them.

And I thought I was making that up.
 
CC: My left ear tingles on tuesdays
Actual patient in the neuro clinic back in my residency days.
 
"I see bugs crawling in my pubs. I asked someone that wasn't high to look and he saw them too".
 
"I be havin blue balls."

Pt later diagnosed with epididymitis :rolleyes:
 
"would like to check out ER" pt was just visiting local EDs to figure out which she liked best...............hu???
 
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The cure for fibromyalgia is a husband that loves you.

My favorite cc:

"My cousin says my [street venacular for vagina] stinks"

mike


Ah, the dreaded acute fibromyalgia attack.

This is usually complicated by >5 allergies to drugs that could be helpful and no one else is allergic to.

and associated axis II disorders

and a family that does not pay enough attention to them

and an unwillingness to listen to helpful information/question anything you might tell them because fibromyalgia pain is "different"
 
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cc: belly button lint
 
All-Star chief complaints: "I am youngest to 500 home runs and all I got was a lousy $350 million contract."

Couldn't resist
 
We had a pt come in who had been itchy in her "female parts"- but that wasn't her worry..her cc was "them blood spots that appeared in the panties after itching down there."

Umm??? I think that's a sign you should stop scratching?
 
"my head is on fire" Pt had shingles
"bugs in my vagina" Imaginary bugs, not real ones, thank God!
"Worms in vomit" Alcohol+linguini....he swore they had been moving
 
Hahahaha.... I love great chief complaints. This would be nothing new to anyone from my program, but we have a list hanging up in the dept. of 'best ever chief complaints'. If I really had a lot of spare time I would type them up for you guys, but there are like 4 pages worth.

From other people:
"Stepped on a rake and it hit me in the face"
"Vagina pain" (from a man)
"End stage fibromyalgia"

From this month in our ED:
"Hit by a flaming plane"
"Bear vs. motorcycle"
"Firecracker to genitals"

My personal additions to best ever CC list:
"I need some Vicodin - because I'm going to a party tonight"
"I ate purple"
"I have abdominal pain... I think it's because someone spit on me"
 
p.s. wussiest CC that I've seen so far:

I seriously had a 24 yr old man who came in for dandruff.
 
YESTERDAY- child's 3 wheeler vs foot.
our status board read:
"tricyclic overtoes"
 
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I loved this anouncment by our MICN:
Tier 2 trauma 10 mins. out. Motorcycle vs. Dog.
I had to ask her which one are we getting?:laugh:
 
EMS brought in a high school age girl who had smoked some marijuana...

CC: "Everything is kinda slow and I am hungry..."

The radio report was a riot.
 
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from this weekend:

"i got anthrax at the mall"

and

"incest bite"

on the tracker, "anthrax" was spelled "amtrax", but the patient was referring to the disease and not the train no one rides anymore.
 
From our ER this month:

1. "My period is 15 minutes late"
2. "I am a dolphin"
3. "I have a bright red waterfall of blood coming out of my ass"
4. "I want to change my name"
 
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From our ER this month:

1. "My period is 15 minutes late"
2. "I am a dolphin"
3. "I have a bright red waterfall of blood coming out of my ass"
4. "I want to change my name"

I just want to combine these into one CC.

"I am a dolphin and I want to change my name because my period is 15 minutes late and now I have a bright red waterfall of blood coming out of my ass."

AKA, a 35 YO female with PMHx of Schizophrenia and OCD with new complaint of bleeding hemorrhoids after scratching back there.
 
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EMS brought in a high school age girl who had smoked some marijuana...

CC: "Everything is kinda slow and I am hungry..."

The radio report was a riot.


I had some kid that alleged to have smoked MJ and he was REALLY hungry... the funny thing was his UDS was negative. Went in to ask him if he honestly smoked something and he said again that he did.. I said well, Someone ripped you off and sold you Bermuda Grass. His parents and he cracked up... got a second round when I said I really just thought you had the munchies after the weed...
 
Have a great one that a fellow resident saw the other day...

"Mold in bathroom....groin hair falling out"
 
cc: Is this a fungal infection?
HPI: group of 1 mm scabs 1 cm in diameter appeared several days ago after shaving. Similar lesions previously resolved after antifungal cream. COuldn't get into the dermatologists office to be seen so came to ER.
Discharge Diagnosis: Razorburn
Bill: ? $200.00
 
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