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Things I Learn From My Patients

Discussion in 'Emergency Medicine' started by docB, May 2, 2003.

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  1. signomi

    signomi Amongst the Gravelings

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    SDN Members don't see this ad. (About Ads)
    If you want the nurse's attention, you WILL get it if you do the following:
    Strip off all your clothes.
    **** all over your room.
    Sit in the midst of it in the lotus position.
    Oh and doing it during shift change gets you bonus points.
  2. Apollyon

    Apollyon Screw the GST Lifetime Donor

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    People will obsess over what that **** could be.
  3. Taaki

    Taaki Member

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    :laugh: :laugh: :laugh:
    The last time I had a patient **** all over his room, I handed him a wash clothe and told him to clean it up, and he did!! :D
  4. Taaki

    Taaki Member

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    Sorry for the double post, but I was reminded..............

    I worked with a tough as nails nurse, she had an extremely drunk, young male patient one night who would not leave the staff alone. Screaming, swearing, violent gestures, the works, we even had security come down to sit outside his room. At one point he stripped down to nothing and proceeded to, um, participate in a little self love, of course security calls us. The nurse enters the room with her "posse" and just looks at the patient. The patient just continued unfazed by his audience. Everyone just kind of looked at the nurse as if to say, "K, what now?" to which she responded, "let him finish, maybe then he'll go to sleep", then left the room. Sure enough, 30 seconds later the patient finished his task and passed out. Not another peep was heard throughout the rest of the shift.
  5. Annette

    Annette gainfully employed Lifetime Donor

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    Socute, maybe he put the bandaid on because he didn't want one of his best prospects hurt by the intern? Besides, putting a bandaid on your own finger can be a bit difficult.
  6. SoCuteMD

    SoCuteMD

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    Haha...hurt by the intern. The intern was threatening me with bilateral central lines and 4 points.

    In any case, when I offered to put the Band-Aid on for myself he gave the reason you suggested. I just found it amusing that the chief of EM was putting a Band-Aid on my finger :).

    Thanks for the confidence, though, BKN :p.
  7. RidingBackwards

    RidingBackwards New Member

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    When you are a hamfisted Fireman and are currently studying to be a paramedic try not to point out a Senior Trauma Doctor's stupidity. 16yo street racer TC'd into a tree with a 25min extrication time...kid was obviously DONE and should have been pronounced dead on scene. I hook up the leads (white is right, Smoke (black) over Fire (red).)

    When they doctor is screaming at you "WHY ISN'T HE HOOKED UP TO THE MONITOR!?!" Resist the urge to first look down at the boys chest with the leads hooked up ...and then to the monitor...and then say to the 25 year doctor "Well...you know I just learned this last week...but I think that rhythm on the monitor is called ASYSTOLE."
  8. WackyWench

    WackyWench New Member

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    Hi, not a doctor, but been around enough of them to have half a clue. (Oh, and I watch ER!... Hah! Okay, so that doesn't really mean much, but I've been wanting to say it all day.) Anyway, vet techie type person who has spent more time an EDs than most of the population of Erie, PA put together. So, here are my tips/learnings.

    1. If you are having severe gall bladder attacks, and the tech checking them out by ultrasound mutters, "Holy ****ing ****!" under her breath... you might want to consider letting them take your bladder and the 30+ stones out right away. It's an even worse idea to take a 2 day train ride across half the country. If you don't, you can wind up spending a week in the hospital and having TWO surgeries.

    2. When you dislocate your knee badly, it's not a good idea to tape it up and compete in a martial arts tourney anyway. Also, when finally being carried into the hospital, it's a really bad idea to show the candy striper the 'neat trick' you can do by bending your leg backwards. She might pass out. (Side note: It's also a really bad idea for your friends to give you the camera to take pictures after discharge with morphine, because they will wind up with three rolls of film with no shots other than pictures of two guy's butts, and the ceiling.)

    3. Scene: You're being transported to the hospital after an MVA in which you cracked the windshield with your head, while wearing your seatbelt. This is a really bad time to ask the ER doc to make the ambulance crew take you back so the competing company can bring you in.

    Okay, those are enough for the night, because the others I can think of aren't really ED ones, and I'm lazy and tired. 10 hour drives are not conducive to good rest.
  9. katrinadams9

    katrinadams9 Working class hero

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    Claiming that you are allergic to Tylenol, Asprin, Ibuprofin, and Aleve while asking for morphine is the fastest way to make friends with all of the docs in the hospital.
  10. ISR

    ISR Junior Member

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    1. Bottlerockets are NOT meant to be launched from ANY BODILY ORFICE, hand held, etc. When you come to see me for your burns, please do not complain to me that the world isn't fair and it's not your fault that you got burned.

    2. If you are "adventurous" enough to burn your "frank and beans" experimenting with "A new type of lube, it was supposed to be, like, wow, man", additional friction will NOT help you heal. Please do not come complain to us when it gets infected. We will laugh at you.

    3. No matter how cool that new prosthetic hand you saw a CNN special about looks, if you have a perfectly good hand of your own, you don't need one. You especially don't need to try to amputate your own hand by wrapping wire around your wrist and plugging it into your house current. (on a side note, he did lose his hand. And his arm. And part of one leg. And part of the other leg. And his life. In that order.)
  11. GoofyDoc

    GoofyDoc Senior Member

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    :confused: Darwin award frontrunner.
  12. Anuwolf

    Anuwolf Removed

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    Well since today's tech is getting much more advanced... and how soo many people (including myself) are a HUGE fan of the terminator movies... almost everybody wants to become a cyborg..

    Just checkout http://www-arts.sssup.it/Cyberhand/introduction/biomechand.htm

    or better... yet

    http://www.modellmarine.de/phpwebsi...id=61&PHPWS_Photo_op=view&PHPWS_Photo_id=1541
    http://pics.livejournal.com/jengagne/pic/00013cgh

    Tell ya what if they start offering cyborg arms like theses... gimme a call so we can make an appointment for an arm amputation!

    also gimme a call if they offer cyborg heads, or any other parts for that matters :D
  13. signomi

    signomi Amongst the Gravelings

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    When the nurse finds the 5 lidocaine patches you are wearing and takes them (and your other 20 hidden in a drawer), it is a BRILLIANT idea to have family bring you more and put them on the soles of your feet. They never look there!
  14. DiveMD

    DiveMD Giggity giggity!!!

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    Never ingest a glass full of lemon Gatorade if it looks suspiciously like coolant...
  15. DropkickMurphy

    DropkickMurphy Removed

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    NOT something I learned from a patient, but something I learned you shouldn't do in the ED: It's not appropriate to swish Mountain Dew around in your mouth after drinking it from a specimen cup and, after spitting it back into said specimen cup, announce "Negative for leukoesterase, but 2+ positive for ketones and glucose". The look of shock on people's faces is priceless.
    TheProphet likes this.
  16. doctawife

    doctawife Rocephin is for wimps

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    Dude, that's just wrong.
  17. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

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    Yeah, Mountain Dew definitely contains leukocyte esterase. :laugh:
  18. DropkickMurphy

    DropkickMurphy Removed

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    No, wrong would be the doc walking out of an exam room licking chocolate pudding off his gloved hand, smacking his lips a little and going "Hmmm.....heme negative, go ahead and give him the heparin." Yeah, that's wrong....I threw up a little in my mouth when he did that.
  19. DropkickMurphy

    DropkickMurphy Removed

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    That's probably one of the few things that it wouldn't test positive for. I've always wanted to run it through an ABG machine and see what you get (other than fired for probably throwing the analyzer wildly out of calibration)
  20. DropkickMurphy

    DropkickMurphy Removed

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    "PCO2- 9254, PO2- 1, HCO3- 23, pH- 3.4, iCa++ 18.4, K+ 11.2, Gluc- 98,434....."
  21. Blue Dog

    Blue Dog Avec caféine. Gold Donor SDN Advisor

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    Run a dipstick UA on it, just for kicks. Since you've already trashed your ABG machine... ;)
  22. ISR

    ISR Junior Member

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    Walking on coals is not a good backyard BBQ activity. Trying it again with socks on to "protect" your feet will not help.

    When you present to the ER, if you want to have the ER staff believe that it was an accident, don't bring your drunk buddies with you, because they will be laughing about how much of a dummy you are and will be sure to regale the staff with tales of your coal-walking exploits.
  23. eandasmom

    eandasmom

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    Hey,

    I'm not a doctor or pre-med, but boy some of these stories are toooo much!!

    LOL
  24. signomi

    signomi Amongst the Gravelings

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    If you have chest pain and you know taking an aspirin is a good idea, then taking 20 must be a BETTER idea!
    Do you hear that ringing?
  25. brokenheather

    brokenheather

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    Not involved in the medical field myself, but have been reading this forum for a while. I became an ER patient Tuesday when I collapsed in a subway station from blood loss from stomach ulcers (naprosyn and me are not friends).

    But the question I needed to pose here is:
    Is it common for ER patients to feel the need to either masturbate or get naked? While waiting for my ICU room, I heard one nurse yell at some gentleman to put his clothes back on. I heard another yell at another room "Sir, stop that! That is not something to do in public!" And when being hauled off to my room, my nurse told me yet another guy had been busted masturbating.

    Was it just an overly self-loving evening in the ER?
  26. docB

    docB Chronically painful Administrator SDN Senior Moderator Lifetime Donor

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    Good question! The simple answer is yes. ERs cater to a strata of society who are marginalized for one reason or another. Many of our patients are sexually inappropriate, mentally ill, status post head injury with frontal syndrome, have poor impulse control due to drugs, alcohol or other issues. These people usually have various health problem in addition to their masturbations issues so they wind up in the Ed a lot. You can also imagine that if someone were on the street and were to whip it out and begin their personal program they would wind up in the ED. Just like all ED patients there's a great deal of boredom and waiting. These folks just have a very inappropriate way of dealing with it. So not only does the ED attract these folks it also brings out the worst in them. In fairness though, as annoying as these patients are I like them better than the spitters.
  27. Chronic Student

    Chronic Student So Fresh, So Clean

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    They'll be spitters, it just takes a little while ;)

    -Mike
  28. DropkickMurphy

    DropkickMurphy Removed

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    Or the ever popular default choice: F. All of the above.
  29. docB

    docB Chronically painful Administrator SDN Senior Moderator Lifetime Donor

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    If you are a habitual pot smoker whose friends describe you as a “mellow, stoner guy” you should be aware that pot is often laced with PCP. If you inadvertently get a hold of a bunch of PCP laced pot and smoke it you may feel compelled to go up to a cop who has pulled over a speeder on the street and tell him that you are being chased by a giant rabbit. The cop may get kind of freaked out when he notices that you have blood all over your hands and pants. When you keep advancing on the freaked out cop while you are covered with blood and shouting about the giant rabbit you will get tazed. Once you are strapped down to a board by EMS and a dozen cops and it becomes apparent that you have gone to town on your package with some type of sharp object EMS will ask why you did it. You should justify your genital self mutilation by saying “The rabbit was after me, man!” because that will clear everything up.
  30. brokenheather

    brokenheather

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    I'm glad that I was safely in my room, bored out of my skull, and not masturbating. The only thing I did that was a no-no was some cell phone use to tell people where I'd disappeared to...

    I just found it odd that I'd hear of three such people during one short (okay, 6 hours stuck in the ER) visit...but yes, it does make sense - particularly since I was in Hollywood where the weirdos flock...
  31. BobbyJ

    BobbyJ Junior Member

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    This is why, if you're going to imbibe, you should grow your own, or get a source who does so who is relatively trustworthy....lol
  32. jess66

    jess66

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    Thanks for leaving this thread public.

    And thanks for the hard work.

    I'm going to remember to bring donuts on my way to the ER next time, ;)

    Please also tell the cops and firemen and EMTs you work with I appreciate them too. You *all* work too hard.
  33. dhb

    dhb Member Lifetime Donor

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    HAHAHA man this is some funny $hit! :laugh: :laugh: :laugh: :love: this thread
  34. JaySin

    JaySin Junior Member

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    The more they spitt the dirtier their face is making it harder to tape an o2 mask on them.
  35. dhb

    dhb Member Lifetime Donor

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    Why not try 4 point restraints and a non rebreather mask :smuggrin:
  36. ISR

    ISR Junior Member

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    You are terrible. I love it.
  37. EM2BE

    EM2BE Elf

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    Me too...I had a really good laugh. :laugh:
  38. flighterdoc

    flighterdoc Rocket Scientist

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    Two axis circumfrential duct tape....
  39. ISR

    ISR Junior Member

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    Patient presented to our ED with c/o burns. He is s/p injury x 6 days. Somehow, the rehab tech (me) got dragged downstairs to evaluate for admit (not sure what good my input is going to do: "Well, doc, those look like burns..."). Patient has cellulitis from not cleaning the burns, a numb, cold, mottled hand from compartment syndrome from circumferential burns to the forearm. When asked why he didn't present the day of the injury, he replied "I thought I could take care of this at home." When asked why he came to the ED today, he replied "The heroin didn't control the pain anymore, it hurts too much and my ass is starting to bleed, too. You guys can fix that, right?"

    That's right. He used heroin rectally to control his pain until his ass bled too much to use the heroin anymore.
  40. Febrifuge

    Febrifuge Grizzled Old Newcomer

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    To be fair, at least heroin does have some painkilling effects. I've learned (several times) that crack is a lousy analgesic.
  41. DropkickMurphy

    DropkickMurphy Removed

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    You knew Feb, the first step to getting help, is admitting you have a problem. :smuggrin:
  42. ISR

    ISR Junior Member

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    When you are the aforementioned individual who was managing your burn pain with rectal heroin, do not be suprised when you are only given oral pain medicine upon discharge, and you are not allowed to keep your central line. In fact, the best thing to do is to threaten the nurse who comes in to remove the central line, stating "You can't take my lifeline! How am I gonna get the good stuff in?"

    You will not get sent home sooner. You will become very friendly with a few of the NCO's on the nursing staff who really aren't going to put up with your s**t.
  43. Febrifuge

    Febrifuge Grizzled Old Newcomer

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    I learned from my patients that the correct response to this is, "Shut the f**k up! You don't know me! Who the f**k do you think you are, ya bal'headed motherf**ker? Don't call me no motherf**kin' junkie!"

    I have also learned that if you watch enough movies, people swearing at you will sooner or later just start to seem like a pathetic attempt to be as menacing as Samuel L. Jackson. Many will try, and few will succeed.

    On that note: an angry, quiet patient needs much more careful attention than an angry, loud patient.
  44. docB

    docB Chronically painful Administrator SDN Senior Moderator Lifetime Donor

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    I have a problem in that I frequently and uncontrolably start laughing when these guys get in my face. Sometimes they start laughing too which is good. Other times they get really pissed which is funny too.
  45. DogFaceMedic

    DogFaceMedic Member

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    Angry and quiet can be very dangerous. Angry and stupid is frequent source of much amusement. But "angry and quiet" means they are thinking. Use generous supply of restraints: physical, chemical, or combination of both.
  46. DropkickMurphy

    DropkickMurphy Removed

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    Or do what I saw happen in a military ED.....the patient (a big drunk Marine who probably couldn't touch his own shoulders) slugged a nurse in the face, a bunch of us (6 or 7 of us) pinned him down and the security forces showed up, and one of them drew a pistol, placed it to the patients head and goes "Calm down! NOW!"

    You know we didn't hear a word from him the rest of the night. BTW, none of us realized that the cop had removed the clip from the pistol before doing this. :laugh:
  47. ISR

    ISR Junior Member

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    Ah. A simple and elegant solution. Now, if only things could work like that more often.
  48. docB

    docB Chronically painful Administrator SDN Senior Moderator Lifetime Donor

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    I can’t figure out how to format this for this thread so I’ll just say don’t do this:

    I get this frequent flier homeless guy in the ER who has various, changing, chronic pain issues. He came in with his buddy who is not a patient and is sitting in a chair next to the bed. I’m booting the guy with a script. He says he won’t be able to fill it because he gots no money. He askes if he can have himself a Vicodans in the ED. I say OK. He then axes me ifs he can have 2. I’m already playing drug dealer so why not. I tells the nurse 2 Vicodans for bed X. 10 min later there’s a Mr. Rush called to bed X which is a security response. I go in and the patient is all in a lather because he wanted to “share” the Vicodans with his buddy and can’t understand why the nurse wouldn’t let him give the buddy one of the pills because they was HIS. This got even more ridiculous when security was taking them both out. The nurse was telling the buddy that we can’t give him drugs because he’s not registered as a patient. So he starts saying that he’ll just register and then can he have some pills.
  49. ISR

    ISR Junior Member

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    If he has no money to fill his script, how the hell is he paying for the ED trip? People amaze me. Not in a good way.
  50. Apollyon

    Apollyon Screw the GST Lifetime Donor

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    Hehehehe...umm...he isn't?

    Unfortunately, welcome to our world.
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