Adages from the ER.

[TooMuchResearch]

Nice guy = metastatic cancer.

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[Siggy]

Psych patients get sick too

My service just admitted a EtOH encephalopathy patient who has drunk herself to living full time at an ALF despite being in her 50s. Recent UTI treated with rocephin than macrobid, but admitted for diarrhea/constipation. Colace BID, lactulose BID... regardless her C. diff popped positive.

Now I hear you saying, "C. diff isn't an emergency." Well, she's at her normal crazy and visually hallucinating, so my attending ordered an MRI (I'm IM)... and it popped for an occipital lobe acute infarct.

Edit:
Also another one from this week:
Rapid response in the psych unit for tachycardia, N/V, HTN. No ABD pain. No chest pain. +AAA on CTA.

 

[Deuce Doc]

Total pathology factor = 1/chief complaints OR 1/patients per room

Somehow, this is frequently the inverse of the impatience modifier...

 

[bravotwozero]

Total pathology factor = 1/chief complaints

THIS. Truer words have not been said. The longer the laundry list of complaints, the less sick they actually are.



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[TorMed]

I'm new to this.

I see a patient in a gown. He's gaunt, confused here because of recent falls in his ALF. He looks old as Hades.

I look at his chart. Expecting to see a dob around 1930. It says 1954. Clearly it's his son's info on the chart. "You're Mr. Bealzebub? Mr. John Bealzebub? From the Last Stop Rest Home"? "Yes" "How old are you Mr. Bealzebub?" "62".

Medicine comes down. Liver going, kidneys pretty well gone. Holy ****. My attending is his age and looks 40 years younger than this guy.


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[WilcoWorld]

Total pathology factor = 1/chief complaints OR 1/patients per room

Somehow, this is frequently the inverse of the impatience modifier...

THIS. Truer words have not been said. The longer the laundry list of complaints, the less sick they actually are.



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Yep. Here's how I heard it: The likelihood that you are experiencing an emergency is inversely proportional to the number of complaints you have. The urgency with which you need to be diagnosed is inversely related to how long your symptoms have been present.

 

[Fox800]

Likelihood of drug-seeking is directly proportional to the number of medication allergies.

 

[Druggernaut]

Likelihood of drug-seeking is directly proportional to the number of medication allergies.

Number of allergies are also directly proportional to the likelihood of a fibromyalgia diagnosis.

 

[gutonc]

Number of allergies are also directly proportional to the likelihood of a fibromyalgia diagnosis.

Allergies to 7 or more medications, 5 or more different classes of medications or 3 or more narcotics have a 100% sensitivity and specificity for a personality disorder.

 

[EM_Rebuilder]

Age + 10% for each rib fracture = Mortality rate.

Age + % of burn = Mortality Rate.

Old people with syncope, if discharged, go home and die.

Colleagues with the nicest cars, the biggest houses, multiple ex wives, or the craziest vacations are the most apt to take the shift your trying to get out of.

LTBD, you have too much to lose. (Extra points if you know what LTBD means?)

 

[deleted245139]

Yep. Here's how I heard it: The likelihood that you are experiencing an emergency is inversely proportional to the number of complaints you have. The urgency with which you need to be diagnosed is inversely related to how long your symptoms have been present.

I'll add this.... 2 complaints is the danger zone....
Belly pain and hematuria- dissection
Arm weakness and CP- dissection
Etc...

 

[Fox800]

Any version of "I'm not drug addict" usually = drug addict.

Same thing for "I have a high pain tolerance".

 

[res1cue]

I think about this one alot: "Nobody ever said 'Thank you for not CT scanning me'"

 

[turkeyjerky]

Any version of "I'm not drug addict" usually = drug addict.

Same thing for "I have a high pain tolerance".

When someone tells me they have a high pain tolerance, I hear "high opiate tolerance".

 

[TorMed]

No, the strangest thing to come out of a woman's vagina, stranger than a revolver or a potato with a plastic doll's head, is a tiny perfect 8 pound new person who has its own unique DNA unlike anyone born before.


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[WilcoWorld]

No, the strangest thing to come out of a woman's vagina, stranger than a revolver or a potato with a plastic doll's head, is a tiny perfect 8 pound new person who has its own unique DNA unlike anyone born before.


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Gonna have to disagree here.

The potato with a plastic doll head wins.

 

[EMDOC17]

Said before in other words but... an allergy to Haldol means you had to receive Hadol before.

The opposite of the nice person being diagnosed with metastatic cancer. "You cannot kill dirt"

 

[gutonc]

The opposite of the nice person being diagnosed with metastatic cancer. "You cannot kill dirt"

I actually say "you can't kill bastards". And I'm an oncologist.

 

[Psai]

I actually say "you can't kill bastards". And I'm an oncologist.

Not according to a certain tv series

 

[JustPlainBill]

If you find yourself spending more than 10 seconds talking yourself out of ordering a test, just order it.

Something just said get a baseline whiteout on this pta.....why? Who knows....came back at 220,000....dead 4 days later after being transferred to a larger onc facility.

 

[gro2001]

Said before in other words but... an allergy to Haldol means you had to receive Hadol before.

The opposite of the nice person being diagnosed with metastatic cancer. "You cannot kill dirt"

I had a patient come in once with anaphylaxis. When I asked him what he thought he was having a reaction to, he opined that it was probably the IM haldol.

Me: "Where did you get the haldol shot?"
Pt: "[nearby hospital] just discharged me"
Me: "Did you tell them you were allergic?"
Pt: "Yup, but they didn't believe me."
Me: "Why did they need to give you haldol in the first place?"
Pt, shrugs: "Was drunk, talking ****."

Well, at least he had insight.

 

[gamerEMdoc]

If you're ordering bloodwork, never ever order a urine pregnancy test unless you physically see a jar of urine sitting in the room. Order a serum qualitative pregnancy test, and you'll get it back two hours earlier.


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