All-Star Chief Complaints

[Druggernaut]

cc: Numb Lips

The triage nurse's note included a quote from the patient, which went something like "My boyfriend was going down on me earlier, and then he kissed me and now my lips feel tingly."

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[Chronic Student]

Reminds me of the time one of our anesthesia techs swiped some lidocaine jelly for "lubrication". He and his girlfriend both came into the ER with what they thought was some horrendous, numbing STD.

We gave him **** for the next two years that I was there and I'm sure he is still hearing about it. Smarts was not one of his gifts!

 

[njac]

Reminds me of the time one of our anesthesia techs swiped some lidocaine jelly for "lubrication". He and his girlfriend both came into the ER with what they thought was some horrendous, numbing STD.

We gave him **** for the next two years that I was there and I'm sure he is still hearing about it. Smarts was not one of his gifts!

I've been told that Surgi-Lube is not an adequate substitute for KY. So no matter what they'd grabbed they wouldn't have what they wanted.

 

[squad41]

Stole this one from a buddy:

CC at a major ED:

I need Dilaudid because I think I have a stapholosaurus infection.


HAHAAH!

 

[Drawing Dead]

"My baby daddy gave me a disease"

"Condom stuck in Vagina"

One i've posted elsewhere: "Garlic soaked cotton ball in vagina x 2 days" and turned out to actually be the clove.

"Well baby check" at 10pm on a Sunday. WTF?

 

[igcgnerd]

At 3am on a Friday night:
Tamp-on stuck
(where could you possibly put it for it to "really: get stuck?)

I have seen people come in for epistaxis with a tampon already up their nose. I say great almost as good as a rhino rocket.

 

[xaelia]

cc: pregnancy test

While on her period - because it was a week late.
And, she thought our pregnancy test was "more accurate" than the one she could get at the dollar store....

 

[sweetfynesse]

cc: nausea and vomiting after eating fettucini covered with sauteed marijuana

 

[146233]

CC: "Farting out my cooch."

 

[deleted109597]

cc: pregnancy test

While on her period - because it was a week late.
And, she thought our pregnancy test was "more accurate" than the one she could get at the dollar store....

Now now, you know as well as I do that a dollar store EPT costs just as much as anything on the dollar menu at McDonalds, and if we force people to choose, we are no better than the Russians. That and both of them cost a dollar more than their free ED visit via the ambulance. Or something like that.
I like how EMTALA forces us to see the "seeking pregnancy test" people. That and the "medication refill" and quite a few others.

 

[deleted6669]

18 yr old single female:
"my mom wants to know why I'm not pregnant yet. I forget the condoms all the time".

 

[shortbread9]

Its always a bad sign when there is no complaint listed and it says "see inside chart" one 85 yo i triaged had this..so i asked her what was wrong and why she was in the ED. she replied, " I dont know, your the doctor! aren't you supposed to figure that out." ---ohh so painful


cc: "Michael Jordan is my father and no one believes me" (white psych patient)

cc: " im here for chronic pain" ----one of my fav's

cc: " My bullet hurts" -Being in baltimore...this is way more common than i could have ever imagined. so much so i wonder why the lazy surgeons dont just take the damn things out!

cc: "there's a clicking sound in my head"

 

[primadonna22274]

I call that the grace and wisdom of our Creator....

18 yr old single female:
"my mom wants to know why I'm not pregnant yet. I forget the condoms all the time".

 

[bikerboy]

2am, middle aged man. CC: I cant sleep. HPI: smoking crack w/friends for several hours, now finds himself unable to fall asleep. States has to be to work at 6am, wants "something to help him sleep"

 

[docB]

"My penis is shrinking." He was serious. Just for my own amusement I refered him to urology.

 

[Jwax]

Just for my own amusement I referred him to urology.

CC: "Swallowed a star"

It was a toddler that swallowed one of those plastic, glow-in-the-dark stars that people put on their ceilings who was now SOB. Think they had to pull the star out of his R lower lobe. Poor kid was pretty miserable. But swallowing a star as CC is hilarious. Especially since I had just watched Stardust a few nights before.

 

[erdocdd]

CC: "My uterine thyroids are causing bleeding."

 

[gutonc]

CC: "it feels like i'm crapping razor blades"

Later he stated "I feel like I've been gang raped in prison."

 

[diphenyl]

Stupid greeters who put in chief complaints:

poss abscess ***** discharge (classic)

teeth itchy

add exacerbation

shortness of breast

air embolism: (This was the guy who was using IV drugs, thought he injected a bolus of air, ran into a neighboring dennys, picked up a table knife and attempted to cut his arm off so he "wouldn't die". Well he got down almost to the humerus and the dennys looked like a horror movie set)

 

[Jeff698]

Pt: "I've got this bump on the back of my leg".

Me: "Does it bother you?

Pt: "No"

Me: "When did you first notice it?"

Pt: "1967".

Me: "cough, cough..." long, long, silence. Crickets chirping..."cough, cough".

I'm with you diphenyl/Dr. Crusher (I'm still in love with that character). Greeters should have to pick from a prefilled pull down list for chief complaints. "Lethargic" comes to mind for the child running around the waiting room.

Take care,
Jeff

 

[Stitch]

I get chief complaints of crying a lot. Usually a smiling 7 month old with nothing wrong who cried for an hour at home. The parents always insist that I 'run tests' to find out why he was crying. I makes me want to cry.

Also 'constipation' because a kid hasn't had a BM that day. Those usually come in by ambulance...

 

[Cerberus]

"Won't stop crying"

16mo pt I've seen 3 times in the last 4 days. Everytime I see him he is sitting on the bed, smiling, not a tear shed the entire exam.

 

[med2UCC]

Seen recently, 16 yo girl, CO "My bug bites itch more when I scratch them". This got her laughed at (Mum commented that if she had a stethoscope and a clipboard she could have been sarcastic at her daughter at home and saved them the trip).
All time favorite (so far) "When my baby woke up she cried". 6 months old and perfectly healthy.
Cheers,
M

 

[DrMom]

"My penis hurts after masturbating and my vision is blurry."


Ended up being a new onset DM presenting with balanitis. I wanted to make some snide remark about grandma telling him he'd go blind from doing that.

 

[24IdaFire]

cc: I had double vision, so I ate some blueberries and it got worse.


Ended up geing a psych admit.

 

[Bojangles85]

cc: I had double vision, so I ate some blueberries and it got worse.


Ended up geing a psych admit.

The snozzberries taste like snozzberries.

 

[gutonc]

"My penis hurts after masturbating and my vision is blurry."


Ended up being a new onset DM presenting with balanitis. I wanted to make some snide remark about grandma telling him he'd go blind from doing that.

That's pretty awesome. From every angle...CC, sxs and dx.

 

[xaelia]

"Can you take out my Implanon? The gynecologist who put it in won't take it out until I pay my bills, and the health department won't do it either."

 

[Termwean]

Co-worker had a pt that CC was " My lips are dry!"

 

[docB]

Came in by ambulance for "I have a question for the doctor."

Question was something to do with vitamins.

 

[diphenyl]

Some CC Jewels as of lately:

- Trying to have BM keeps getting sucked back in (new medical term I guess for reverse rectal peristalsis)

-sexually active (parents caught 13 YO having sex with 13 yo BF so brought her in to be checked out)

-"head empty" (obviously if you think to tell the triage nurse this is whats wrong with you)

- foot problems (no not orthopedic or extremity issues, the other "foot" problems)

and here is the winner

- smoked meth, feel high

 

[EMS5]

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.

Did you legit test this out? I might have to write this on a post-it note and put it on the back of the medic so we can start advising the ED of possible 300's patients (300's is the psych unit in the ED)...

Back in my clinical rotations for medic class...the doc told me to go in and do an pmh/hpi/quick physical on an early 20's guy with chest pain.... while doing the social history:
"smoke?"---no
"drink?"---not often, haven't in a couple weeks
"any recreational drugs?" --well i smoked crack and weed a little while ago

 

[nlax30]

"I'm a product of incest"
A middle-aged female with general chronic pain/fibro complaints that she attributes all to supposedly being a product of incest.

 

[EMDoc0411]

"I peed a worm"

Turns out she was pregnant with nausea and pelvic discomfort. I'm still not sure how a worm ended up in her toilet.

 

[rvfb]

.

 

[Interpolfanclub]

Doc: "What brings you in sir?"

30ish Indian male in heavy accent: "I was masturbating and got the worst headache of my life, and I read on the internet that I could have a subarachnoid hemorrhage."

One head CT later - final diagnosis: SAH, admit neurosurgery.

I had a prof in med school tell me that if you listen hard enough, the patient will tell you the diagnosis...

 

[Arcan57]

Doc: "What brings you in sir?"

30ish Indian male in heavy accent: "I was masturbating and got the worst headache of my life, and I read on the internet that I could have a subarachnoid hemorrhage."

One head CT later - final diagnosis: SAH, admit neurosurgery.

I had a patient that came in because he was reading on the Internet that having massive bleeding from your rectum can be a problem. Why he needed the Internet to tell him that...

It's always fun when BRBPR is from a UGI source.

 

[med2UCC]

A few weeks ago, 6 month old girl with P/C of "her cousin kissed her an hour ago and he had a cold..."
Perfectly healthy little girl with ***** parents.

 

[substanceP]

CC from a few nights ago:
"It just drama. That is why I am here."
(she was right. it just drama)

CC from last night:
"I got a bubble in my rectum and it's getting bigger now."
(perirectal abcess)

 

[cyclohexanol]

1) CC: "abdominal pain" (doesn't offer any more info, suspect rectal FB)
Me (after standard questions for abd pain): "did you stick something in your rectum?"

*pt looks at me like I'm ****ing insane*

Pt: "No! I put it in my penis!"

One abd CT later, pencil located, eraser end in bladder, tip lodged in prostate. Urology couldn't get it endoscopically, had to have open cystostomy.

2) CC: "I feel like my eyes are going to hurt tomorrow"

3) CC: "i want to be tested to see if I'm still a virgin" (15 y/o male)

4) trauma alert motorcycle vs car @ 35mph
HPI: motorcyclist ejected 20 feet, helmeted but helmet not present
Me: "Sir where is your helmet?"
Pt: "It's probably near the accident, after I landed I got up and pulled the driver out of the car and started beating him over the head with it."

 

[Cerberus]

1) CC: "abdominal pain" (doesn't offer any more info, suspect rectal FB)
Me (after standard questions for abd pain): "did you stick something in your rectum?"

*pt looks at me like I'm ****ing insane*

Pt: "No! I put it in my penis!"

One abd CT later, pencil located, eraser end in bladder, tip lodged in prostate. Urology couldn't get it endoscopically, had to have open cystostomy.

2) CC: "I feel like my eyes are going to hurt tomorrow"

3) CC: "i want to be tested to see if I'm still a virgin" (15 y/o male)

4) trauma alert motorcycle vs car @ 35mph
HPI: motorcyclist ejected 20 feet, helmeted but helmet not present
Me: "Sir where is your helmet?"
Pt: "It's probably near the accident, after I landed I got up and pulled the driver out of the car and started beating him over the head with it."

That reminds me of one I saw as a medstudent.

CC: abd pain

Pt makes no mention of why he might have abdominal pain...CT shows large dildo in rectum.

 

[Colbert]

CC: "I hate my penis"

Psych patient that somehow got two 2" screws off of the toilet seat and shoved them up his urethra before any of his in-patient staff noticed.

 

[diphenyl]

CC: testicular pain
30 is male c/o actually penile pain, no abd pain or urinary or STD like sx's. After about 15 min's of hx taking he finally admits he placed a good and plenty in his urethra out of consideration for his wife during oral sex and it was stuck.

 

[docB]

Just yesterday:

Came in by ambulance for "I want a referral to a surgeon to fix my chronic hernia."

No acute pain or other symptoms. Patient had recently decided to start working out, k ew he neede to get his hernia fixed, read about some new "laser surgery" where you're only out for a day or two and wanted to discuss it. So he called 911.

Odd thing was he wasn't under the illusion he could just get the surgery through the ER like lots of people are when looking for elective surgery. He we perfectly happy with a referral.

 

[BF2BC EMT]

CC:

Pt-Tooth pain, followed by "I was told to come here to have my wisdom teeth pulled"

Another guy came in who was hit in the head with the brick part of a laptop charger when his wife found out he had secretly made an eHarmony account and was actively using it

 

[The White Coat Investor]

Knee pain-Doctor's note

Last night had this 14 year old male come in. He had some brief knee pain at football practice and the coach told him he couldn't play in the game the next morning without a doctor's note. No pain now, of course. I ran him up and down the hallway a couple times, wrote the note, and discharged him. I wonder if the coach will pay the bill.

 

[Laryngophed]

CC: testicular pain
30 is male c/o actually penile pain, no abd pain or urinary or STD like sx's. After about 15 min's of hx taking he finally admits he placed a good and plenty in his urethra out of consideration for his wife during oral sex and it was stuck.

At least he is thoughtful.

 

[omgwtfbbq?]

..... that..... sounds like it would burn. I mean, more than the usual pain of sticking something up your urethra. I'm going to assume that hurt more than the fellow with the good 'n' plenty up there but less than the guy with the copper wire and watch battery

 

[Khaos]

"My wife is poisoning me"

When pt masturbated he said that clear stuff came out before the white stuff did and he thinks she is poisoning him.

 

[Khaos]

"My wife is poisoning me"

When pt masturbated he said that clear stuff came out before the white stuff did and he thinks she is poisoning him.

"pregnancy test"

I have an appointment with the health department in 2 hours but I didn't want to wait to find out.

"I can't fall asleep"

When I went into the room the patient was asleep. He said he liked the noise in the ED and it put him to sleep. We let him sleep in the waiting room since it wasn't too busy at the time.

"I'm having hiccups"

Which means that you are having esophageal strictures, hypokalemia, hypochloremia, acute renal failure, and obviously your hgb dropped from 11 to 6!!! Thus what was going to be a quick in and out at the end of the shift ends up being getting out of the shift one hour late for me.

"my period lasting longer than normal"

7 days instead of normal 5 days.

Trauma page overhead "A level I penetrating, blunt, MVC, GSW"

Got into fight at a bar while drunk, shot in the upper arm, tried to drive home to tell family he was going to the hospital and ask someone to drive him but wrecked and flipped the car.