Things I Learn From My Patients

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I learned the other day that you can be so drunk that after losing control of your van you can get yourself tossed out of the passenger window, only to be hit by your van. then when asked by the police if the van is yours get excited that you own a van!
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Improperly placed tools are a hazard. When you discover exactly what the hazard it is, it hurts like hell. When you go to the ER because three rake tines penetrated your foot when you stepped blindly backwards onto said rake, two of which went completely through the foot, the mess is considerable, the painkillers are good, and, if you are calm and polite, the emergency staff tends to treat you quite well, considering you've given quite a bit of evidence towards the idea that you may be just a bit stupid.

Pizza Hut supreme thick crust tastes just as good on painkillers as it does with beer, and it's amazing how attentive and friendly the staff gets after you have 7 pizzas delivered, and announce that you were intending to share with the whole staff, when you ordered.

I was, however, advised not to do the pizza/beer combo for at least 24 hours after discharge. Or when I was under the influence of the painkillers. Or when I was going to work on landscaping construction projects (I was sober when this happened, but the nurse who actually signed me out took care to note that drinking and working to complete the project wouldn't really be advisable, considering what I did to myself sober).

And yes, I got lectured on the inadvisable choice to order, and begin to eat, pizza when it had yet to be determined exactly what level of reaction would have been required as ER care response...heaven forbid I cause them to know, rather than suspect, that a general anesthetic was inadvisable due to food consumption reasonably close to time of injury. I suppose I got lucky, though, no surgery was needed, on an immediate basis...
 
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I'm just a student but I had an really special day of learning yesterday.

First I learned that going into the bathroom to smoke isn't nearly as sneaky as one might think. It turns out that everbody can smell the burning tobacco throughout the entire floor even if one hides in the bathroom.

The I learned that if you come in with signs of an acute stroke and then get caught by the nurses snorting coke you will get all of your belongings searched carefully and you will get put in restraints and you won't get any painkillers.

From the same patient I learned that while medical professionals are used to all sorts of crazy MDRO bacteria and such and don't blink an eye and just wear gowns and gloves; if instead you have crabs the nurses will be trying to switch off your case and you will get the fastest stat derm consult I have ever seen and people will be wearing hair nets and double booties and double gloves when they go in your room.
 
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If you have cocaine induced vasospasm on Saturday and D/C yourself AMA on Monday, yes, you likely will represent with chest pain. You shouldn't expect much sympathy the second go round though.
Cheers,
M
(wondering what delights Friday night holds in store...)
 
Apparently disposable stethoscopes and a roll of medipore tape can become a fishing apparatus for the sharps container to obtain partially used vials of narcs and syringes. And if the nurses were properly wasting like good nurses, then just cheek your oxycontin, crush it, use the leftover saline from the bottle from your dressing change, mix in a syringe you fished out of your sharps container and shoot it up your PICC line.
 
I'm only a vet tech, but wanted to contribute as this thread has occupied much of my free time the past few weeks.

Veterinary related, but hopefully amusing.

No, feeding your dog cotton balls to absorb the antifreeze you caught him drinking isn't a good idea.

Garlic and tobasco sauce is not an effective dewormer no matter what the internet says and yes, it's probably what killed the first two puppies.
 
1)If it's a busy night when you come in painfully constipated because you stopped taking colace along with your chronic narcotics for your multiple pain syndromes, you will get a hall bed despite having arrived by ambulance. When I interview you and tell you I'm arranging for a more private place for us to do this disimpaction (O Joy), please continue to periodically bear down, red faced, right there in the hall. Not 5 feet from other patients and just outside of x-ray, so plenty of traffic. It's okay, everyone else wants to see and hear you. Also, your husband should keep lifting the sheet up to check and see if you've had any result.

2)The most appropriate therapy for a bong left in a vagina is pumping the stomach, this will definitely get the bong out. (Fixed delusion, had been seen for this complaint many times, the really zany part was that after the normal bimanual we finally caved and did an endocavitary ultrasound and she had a big dermoid. Fun explaining that without exacerbating the delusion).
 
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If you are talking so much that I can't elicit a proper medical history from you during the 20 minute transport to the hospital, you can rest assured that your shortness of breath is of the "neck-up" variety
 
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When you have a primary school student, who to all appearances has BBBAAAADDDDD ADD, by all means hand him a lit firecracker on July 4th. What could possibly go wrong?

Our friends and neighbors in Ophthalmology will be happy to come in at oh-dark-hundred, in order to assess the resultant (and completely surprising) corneal burns!
 
Yesterday I learned if someone in your car needs medical treatment (I am not sure what type), you should stop in the turn lane of a major street crossing a US Highway, get out of the car, walk around with your cell phone calling for help, not put on flashers or raise the hood, bind up traffic, wait 6 minutes for the police, then wait 10 more minutes for an ambulance, instead of driving one mile west to urgent care or 3 miles north to the nearest ER. Bonus points for doing it during rush hour.

(Saw it while eating. Cops arrived just as I was about to go offer some kind of assistance.)


Also, this warning:

4ddd2bed689dc.jpg


exists for a reason...
 
ERMudPhud said:
Along the same lines there was a mundchausens patient we all saw at various hospitals who was a young male with a history of lymphoma who would fake massive GI bleeds (hematemesis) to the point of getting central lines and endoscopies all over town. With no source ever found it was never clear how he was faking the bleeds. A few years later I was telling two friends from LA about him and I only got halfway through the story before they both started laughing, completed the patient's history, and told me he had made the rounds of all the LA hospitals as well
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We had that patient in Ohio during my residency. He was drawing off of his IV (or other) line and putting it in his mouth, a quick withdrawl of all of his lines he got better (but even taped this guy was good, we had to initially sign across the bandages securing his lines, as bad as our handwriting is... you can recognize your own). So hard to d/c a line in someone who may be bleedin.. ugg. He got intubated. And they flushed and then extracted the flush from his stomach, clean! Got a psych consult (refused) and got d/c'd... went across the way to the next hospital. God loves medical students who practice at all of the hospitals in the area... saved their hospital a few thousand...

As for the concrete up the anus for the ping pong ball. Well isn't there an article about removing light bulbs with plaster of paris? Use to put 1 crazy citation in every paper we wrote (like coconut head trauma victims in hawaii)... I seem to remember that one, but that was more FOR the surgeons to remove without it popping, no so much to avoid the trip to the ER. I'll try and find it later, but while looking I did find the account of the ping pong ball and the concrete >.< http://www.well.com/~cynsa/cement.html with photos. >.>
 
I learned that when checking into the ED, a perfectly acceptable CC is "possibly pregnant.'

The funny thing is I saw this twice in the same night last week.

Dsoz
 
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If you decided to OD on seroquel you should probably make sure your son, who has personal experience with seroquel overdosing, comes with you in order to educate us on seroquel overdoses while we are intubating you.
 
correct I learned that 20 years of ER RN experience, and 20 years of paramedic experience, will not help you effectively respond to your five year old child who has, right in front of you, stopped a pitched hardball with his left maxilla (cue "WTF?" re: 5 year olds pitching to 5 year olds in the firstplace). I _did_ manage to leap the fence and hold my crying child, murmuring comforting nonsense. Another parent (farm mother, of course!) suggested perhaps an ER visit might be reasonable (cro-magnon man grunt of agreement), yet another thought (out loud) that an x-ray might delineate the underlying injury more effectively than standing in the middle of an arrested Pee Wee baseball game, and yet another wondered where all my crap was (Thank Ghod _somebody_ was doing my thinking for me!).

Lessons? #1. Be humble, I will earn it
#2. I love living in a small town. God bless my neighbors.
#3. I will be just short of useless in the ER. Despite that being the ER in which I work regularly. Just like everybody else, I will find my child being injured, to be just a LEEEETTTTTLLLE bit distracting.
#4. Engage the "WTF?" filter sooner than later. Had my brain been engaged, and I answered that question (like by snatching him from harm's way, fer instance...), my child might have avoided that particular little adventure.
 
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If you are doing coke in a bathroom stall and you hear the police come into the bathroom you should not attempt to dive into the toilet. You will not shoot down the drainpipe like you are in a Bugs Bunny cartoon and be delivered safely to a seashore somewhere.
 
docB said:
If you are doing coke in a bathroom stall and you hear the police come into the bathroom you should not attempt to dive into the toilet. You will not shoot down the drainpipe like you are in a Bugs Bunny cartoon and be delivered safely to a seashore somewhere.
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Wait...coke or acid? Because if it was coke, that was some pretty f'd up coke.
 
gutonc said:
Wait...coke or acid? Because if it was coke, that was some pretty f'd up coke.
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Coke. With etoh, THC and opiates on board before he tried to Greg Louganis into the hopper.

It suggests this corellary:

If you already have a pretty strong polysubstance buzz happening you should decline when asked to go to the bathroom for some blow.
 
docB said:
If you are doing coke in a bathroom stall and you hear the police come into the bathroom you should not attempt to dive into the toilet. You will not shoot down the drainpipe like you are in a Bugs Bunny cartoon and be delivered safely to a seashore somewhere.
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what? since when do the laws of physics and matter not work like in cartoons?
 
That if you prove to be a really troublesome ETOH user and bite a nurse not only will you get a hot shot of sleepy-time in your ***** but when you wake up you might be surprised to find yourself in a spit sock, strapped to the bed, and in some kind of contraption that looks like a crib for grown ups.
 
If you are unconscious, wake up and extubate yourself, then become unconscious again with a higher alcohol level than you initially presented with 12 hours earlier, we will find the empty bottle of alcohol hand sanitizer. And of course re-intubate you.
 
If you're a barely drunk college kid who is so bent up on your rights to have your doctor and only your doctor enter your ER room, shouting "if you violate my right and come into this room, I will violate you!" very loudly to the female nurse will of course get her out of your room. Unfortunately, it may get some really big security guards to come into your room to tell you what is acceptable behavior, and earn you a visit to the psychiatric ER where you will have a much bigger room, although a little less private
 
in my own experience ( i'm a pre-health/pre-med student) from multiple trips to the ER and excellent observation skills, if one says 'get off me i'll kill you if you touch me' after being stabbed 5 times (thigh,chest x2, right abdo,fore arm) and a GSW to the Neck the treating physicians will laugh at you and walk off.....only to return with 50mg valium and two very big security guards followed by being wheeled into the padded ER treatment area and a call to psych!

2. if you come to the ER drunk and curl up on the floor then proceed to vomit your entire stomach contents on the floor expect no sympathy and to clean it up yourself...(thats australia for yeah ;) )

3. Do not call the lovely nursing staff horrible names while drunk otherwise you'll cop it from the RMO
4. If you're in DKA and when you finally come around expect to be yelled at by the doctor ..especially if it's your 6th visit to the ER in 3weeks due to DKA and you've had diabetic ed

5. Do not fake pain...you will not get narcs! if you cannot walk due to back pain and that is your CC then i expect you not to be able to walk to the vending machine or toilet...take 2 panadol and 2 neurofen, go to bed and stay there. if the pain worsens go to your GP...thats what they're there for!

^^those 5 things there, they are from the 5 times i was taken and admitted to hospital due to IIH headaches..4 LP's later and hopefully the cycle is broken
 
That rotten tooth will probably not be fixed by having your friend draw up 10ml of car battery acid and squirting it on that sore molar.

On the other hand it is a good way for a gastroenterologist and ENT to collaborate on building you a shiny new oropharynx.
 
Hayduke said:
That rotten tooth will probably not be fixed by having your friend draw up 10ml of car battery acid and squirting it on that sore molar.

On the other hand it is a good way for a gastroenterologist and ENT to collaborate on building you a shiny new oropharynx.
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Welcome back - it's been a while.

HH
 
This thread is the reason I started volunteering in the ED (well, a reason).

keep em' coming and maybe I can contribute someday :).
 
When i was on my opthalmology rotation we had a patient present to the ER in the Eye and Ear hospital with a cc of "I poked myself in the eye and it hurts" :rolleyes:

I also work with a volunteer ambulance service (similar to the St John's Ambulance), was on duty at a music festival during the summer when a patient walked into the first aid post claiming to be a medical student and that she had a tib/fib fracture, the EM consultant on duty took one look at the patient's leg and told her to go away.
 
It doesn't matter how far off the road your cabin may be. Under no circumstances should moose be used as a form of transportation.

First day volunteering in the ED and I'm already learning things from my patients. This is going to be fun.
 
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When taking a valium to be able to relax on the long flight, make sure it is the valium you take and not the other little blue pill you acquired while away.
 
NoxNox said:
When taking a valium to be able to relax on the long flight, make sure it is the valium you take and not the other little blue pill you acquired while away.
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"Nox" is awfully close to nitric oxide... so how did that flight go for you?
 
Taser barbs can not be removed easily from breast implants. When removed, the implants tend to leak & have to be replaced.

Having a full beard and smoking while on home O2 will lead to burning your beard off.

Sux is the ultimate chemical restraint.
 
exi said:
"Nox" is awfully close to nitric oxide... so how did that flight go for you?
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It honestly was not b´me. I'm a chick, I don't need viagra :p (and , can't afford to go anywhere that requires a long flight *sulks*)
 
If you're talking to your baby momma on the phone in the Visits area, and the inmate next to you disses you, don't punch him in the face. Punching is so mainstream. Instead, bite him on the chest. He will retaliate by biting you on the face hard enough to take off a chunk below the left eye.

I mean, there's mad, and then there's so mad, you need to tear flesh off the other guy's face with your teeth. I don't know if I could ever get that pissed off.
 
I learned that it's a fantastic idea to (intentionally) take a lot of GHB and then drive down the freeway. With a cockring on.
 
NoxNox said:
It honestly was not b´me. I'm a chick, I don't need viagra :p (and , can't afford to go anywhere that requires a long flight *sulks*)
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viagra doesn't do anything unless you are actually aroused. it keeps the smooth muscle relaxed to keep blood in the vasculature- it doesn't just magically give you an erection.

sorry for being a pancake, but you gotta sift through the real and the fake :p

Now if that pill happened to be MDMA, I could see an issue :D
 
Clinical pearl: if you are obese and have a history of urinating glucose, get checked for type II diabetes before you take large doses of prednisone daily for recurrent asthma attacks. Your blood sugar may sharply rise to 1600mg/dl and you might just go into a hyperosmolar coma while alone in your apartment.

Luckily, a neighbor found her before it was too late and the patient was able to make a sound recovery. And the good part is that now she takes insulin;)

:luck:
 
Something I've learned while volunteering in the ER...

When you are drunk off your *** do make sure you go through the correct door when you are looking for the bathroom or you may end up falling down a flight of stairs, and proceed to break a big toe and hyperextend a finger to the point of pulling the skin apart to the bone.

Also, from the same patient, do not cry like a baby when the doc goes to inject a nerve block because your dad will proceed to look you in the eye and tell you to "cowboy up."
 
If you have GERD, do not drink a liter of punch containing carbonated beverages, strong citrus and grain alcohol. It will strip the lining from your stomach and you'll not only be hungover, but in excruciating pain as your GI tract gamely attempts to recover. However, award yourself bonus points for finding an empty box to regurgitate into instead of the hotel carpet.
 
If you get a battery stuck up your lady parts, do not then chase it with quarters. It is not a vending machine.
 
MikeWilliamson said:
If you have GERD, do not drink a liter of punch containing carbonated beverages, strong citrus and grain alcohol. It will strip the lining from your stomach and you'll not only be hungover, but in excruciating pain as your GI tract gamely attempts to recover. However, award yourself bonus points for finding an empty box to regurgitate into instead of the hotel carpet.
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Excellent mental picture! :laugh:
 
The proper course of action for severe worsening ankle ulcers that are weeping horrible smelling pus is to use Bounty, the Quicker Picker Upper, to bandage your legs...for 15 years. Of course, this would never lead to an xray like this...

I never thought i'd actually see such an xray in the US...
 

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Rendar5 said:
The proper course of action for severe worsening ankle ulcers that are weeping horrible smelling pus is to use Bounty, the Quicker Picker Upper, to bandage your legs...for 15 years. Of course, this would never lead to an xray like this...
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Everyone knows the correct treatment is duct tape...
 
Rendar5 said:
The proper course of action for severe worsening ankle ulcers that are weeping horrible smelling pus is to use Bounty, the Quicker Picker Upper, to bandage your legs...for 15 years. Of course, this would never lead to an xray like this...
Click to expand...

2q0mwcj.gif
 
Can't get the woodstove lit? Black powder to the rescue! A tin can full of gunpowder poured on a smouldering fire will explode like a hand grenade, rapidly igniting even the soggiest firewood.

Oh, it will also remove fingers.
 
Rendar5 said:
The proper course of action for severe worsening ankle ulcers that are weeping horrible smelling pus is to use Bounty, the Quicker Picker Upper, to bandage your legs...for 15 years. Of course, this would never lead to an xray like this...
Click to expand...

Oh my.
 
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