Bad Chief Complaints to Have in the ER

[docB]

I gave a lecture on this to our students the other day -

Vomiting blood - You say you did this you get the NG tube
Worst headache of my life - translation: I want an LP
I'm a male with penile discharge - brace yourself for the urethral swab
I'm a female with abdominal pain - =pelvic
My 1 month old has a fever - you will be amazed at the cruel acts of medicine we are going to inflict upon him

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[paramed2premed]

I want to hurt myself - prepare to spend hour after hour in the ED waiting for the ES worker to arrive, talk endlessly about your self-immolatory desires, and wait yet more while every psychiatric unit in the state is given their chance to turn down your placement.

 

[tussy]

Originally posted by docB

Worst headache of my life - translation: I want an LP

I can relate to this one. I just got out of hospital after being admitted for a week with meningitis. I was on call when the pain struck. I sat in my call room for a few minutes with the worst headache of my life, a stiff neck, and a fever contemplainting this very thought, when i realized i had no choice but to wander down to the ER, and and state those very words. Then i rolled on my side and waited for that big spinal needle. OUCH.

 

[Celiac Plexus]

Originally posted by docB
I gave a lecture on this to our students the other day -

Vomiting blood - You say you did this you get the NG tube
Worst headache of my life - translation: I want an LP
I'm a male with penile discharge - brace yourself for the urethral swab
I'm a female with abdominal pain - =pelvic
My 1 month old has a fever - you will be amazed at the cruel acts of medicine we are going to inflict upon him

Don't worry future EMers, cos' here's what these complaints really mean....

Vomiting blood - Consult GI
Worst HA of my life - Consult nsurg
penile d/c - consult urology
female c abd. pain - consult surgery
1 mo old with fever - consult peds

 

[mikecwru]

Originally posted by Celiac Plexus
Don't worry future EMers, cos' here's what these complaints really mean....

Vomiting blood - Consult GI
Worst HA of my life - Consult nsurg
penile d/c - consult urology
female c abd. pain - consult surgery
1 mo old with fever - consult peds

Go cut out a hemorrhoid.

mike

 

[ERMudPhud]

Actually, in my ER I work up all 5 of those complaints without calling anyone until the diagnosis is made AND cut out my own hemorrhoids

 

[The White Coat Investor]

If a surgeon really thinks EPs consult a surgeon for every belly pain that walks in, maybe we should consult him for every belly pain for a week until he realizes what a low percentage of them he is consulted for. In the real (non-academic) world, most surgeons appreciate a good EP because:
1) A good EP screens out most of the non-surgical bellies
2) A good EP refers patients ($ in surgeon-speak) to them
3) A good EP cleans up their wound dehiscences/infections for them so they don't have to crawl their crabby asses out of bed at 3 am to come do it themselves.

Anyone who doesn't appreciate a good EP hasn't had the pleasure of working with one. (That being said, there are at least as many mediocre EPs as there are mediocre surgeons.)

 

[docB]

Don't worry future EMers, cos' here's what these complaints really mean....

Vomiting blood - Consult GI
Worst HA of my life - Consult nsurg
penile d/c - consult urology
female c abd. pain - consult surgery
1 mo old with fever - consult peds

Not in my house. We work all that crap up ourselves. Try to consult any of these too early (defined as prior to being ready for discharge) and my consultants whine and pitch fits like cranky two year olds.

 

[mojo]

Don't worry future EMers, cos' here's what these complaints really mean....

Vomiting blood - Consult GI
Worst HA of my life - Consult nsurg
penile d/c - consult urology
female c abd. pain - consult surgery
1 mo old with fever - consult peds

By the way, its

Vomiting blood - Consult ICU/GI
Worst HA of my life - Consult nsurg
penile d/c - consult public health
female c abd. pain - consult ob/gyn
1 mo old with fever - admit to peds

You probably consult cardiology for hypertension, eh?

 

[Annette]

Originally posted by ERMudPhud
. . . AND cut out my own hemorrhoids

How did you handle the mirror and the scaple at the same time?

Sorry, I just couldn't resist!

 

[eddieberetta]

How did you handle the mirror and the scaple at the same time?

Dr. Jung's anal mirror. Worth a veritable foortuna!

 

[Tazmaniac]

CC: (per police) Pt found masturbating in busy intersection, throwing excrement at cars.

During my psych rotation, go figure.

-Todd USC