All-Star Chief Complaints

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cc: Chronic penis pain. From one of the most expensive medicaid pts in the county. Had serious mental illness, would often come into ER after the cops beat him up for whatever minor crime. Had lots of U/As, STD tests, scrotal US....Turned out it was an extensive bladder tumor.

cc: Hirschsprungs. Little girl, father was neurologist. pt had no hx, but hadn't pooped in a week. Father said "I've only seen this in hirschsprungs!" Wanted rectal manometry (in the ER!). Gave her glycerin PR - and "cured" her. Father was very upset he didn't think of constipation.

cc: "I feel like I have a ruptured etopic". Turns out she was right, over >2L of blood in abd cavity with the OB's opened her up.

When I was an EMT. Dispatched to a "toe pain" at 2am. Pt then coded in ambulance, so beware the deadly toe pain sign.
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My mom was a triage RN at a level I trauma center in the mid 1970s. She once had a patient present who had driven himself to the hospital, and walked himself into the ED complaining of moderate, nonspecific chest pain. He didn't seem particularly concerned, distressed, or uncomfortable in relation to his presenting complaint. He was calm and pleasant during the routine registration process, and remained perfectly cooperative when he was asked to take a seat in the lobby until a bed became available back in the ED core.

He took his seat and waited there patiently, without making a peep, for a fairly significant time. Then, after something like 30 or 40 minutes had elapsed, he calmly walked back up to the triage desk and slowly lifted up his shirt--to expose the handle of a quite large kitchen knife, the entire blade of which had fully punctured through his chest wall, and was firmly lodged within his thoracic cavity at a grotesque perpendicular angle.

Apparently, he didn't feel the need to specify to my mother, the suddenly astounded triage nurse on duty, that his chest was hurting because he had just gotten brutally stabbed by his violent soon-t0-be-ex-girlfriend.

Needless to say, after his revelation, he didn't have to wait in the lobby for another second.
 
Necrobump.

So, my wife is a chef. She shared with me an analogous thread over on ChefTalk forums about "bizarre orders". Anyone with a food/bev background could get a good laugh out of it in the same fashion as this thread. People ask to split a hamburger; but cook it at two different temperatures, for example.
 
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From the peds ER: Infant's mom: "I can't see the vagina hole."

Turns out she was semi-right...the patient had some pretty significant labial adhesions.
 
-Insomnia

-Disability paperwork

-Follow up on a spot on my lung they saw on a chest X-ray a few years back
 
2 days of insomnia. Associated with her 3 day newborn baby at home.

Decision made to electively intubate so we could both sleep better that night.
 
"Would like to donate a testicle."


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Cc: The baby's coming!

Truth: Patient was not pregnant. And while "laboring" proceeded to defecate on the floor.
 
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…
 
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"Staph Scalded Skin" 19 year old hot shot got on webMD and diagnosed himself. He had acne. How you're a college sophomore and don't know what acne is...

"Chapped lips" 1 year old with level 1 chapped lips at 11pm on Monday.

"Fuzzy dice in vagina" This one is self-explanatory.
 
Dakota said:
Patinet: I have stage V fibromyalgia

Me: I can't say I'm familiar with fibromyalgia staging. What defines stage V?

Patient: I don't know. But it's worse than stage IV.
Click to expand...

I often stop at my local supermarket for snacks prior to a nightshift; scrubs on. The crew knows I'm a doc. I had a gal ask me the other day if I "knew any doctors that specialized in fibromyalgia."

SMH.
 
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"Thinks he's superman." Me: maybe he is ...
 
"Penis problem, toe injury -unrelated"
 
saw these last night:

20-ish y/o M : "I asked my friend to stick his finger up my bum last night and now my bum hurts. We're just friends btw."

and

25-ish y/o M: "I'm dating a girl for the first time ever and after two weeks I don't feel as interested in her as I used to. Do you have any pills to fix this?"

and

peds 3-fer signs in with "A few kids at school have been diagnosed with strep and my kids don't have any symptoms but I just wanted to get them checked in case they need prophylactic antibiotics."
 
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Arcan57 said:
Apparently that pays $75k these days?
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Well, then I can see why someone would consider that a legit emergency. Maybe he had a 6% interest rate on his student loans?
 
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"I got a boil on my couchie".
 
Last night 3 checked between 0230 and 0330

"Stolen wallet, EMS"
"No complaint"
"Feeling supernatural"
 
Dakota said:
Patinet: I have stage V fibromyalgia

Me: I can't say I'm familiar with fibromyalgia staging. What defines stage V?

Patient: I don't know. But it's worse than stage IV.

An ER I previously worked in let patients type in their own chief complaint that would show up on our rudimentary tracking board (I swear it was Excel based). This led to the predictable misspellings and hilarity. One popular complaint was for abscess or purulent discharge. The board would read "Pu**y drainin" no asterisks of course... Although on occasion it would turn out to be a genital complaint and not an abscess at all. Never quite knew what you were going to get when you saw that on the board.
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OMG are you in Texas? I started telling my Fibro pts the stage of their illness a couple years back. Once they tell me they have fibro I pull up a chair and act very concerned and let them go through all their symptoms. When they finish I'll say hmmm that sounds like stage V Fibro, you better f/u with your pcp about that.
 
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allendo said:
OMG are you in Texas? I started telling my Fibro pts the stage of their illness a couple years back. Once they tell me they have fibro I pull up a chair and act very concerned and let them go through all their symptoms. When they finish I'll say hmmm that sounds like stage V Fibro, you better f/u with your pcp about that.
Click to expand...

I'm gonna stab you if you're serious....
 
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allendo said:
OMG are you in Texas? I started telling my Fibro pts the stage of their illness a couple years back. Once they tell me they have fibro I pull up a chair and act very concerned and let them go through all their symptoms. When they finish I'll say hmmm that sounds like stage V Fibro, you better f/u with your pcp about that.
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Had a difficult patient a few weeks back who wanted to tell me all about her Ehlers-Danlos syndrome and how it was intimately related to her chief complaint (it wasn't).

To convey interest and concern I furrowed my brow and asked which subtype of Ehlers-Danlos she had.

She replied "the type that effects connective tissues."

[facepalm]
 
brought in by EMS "tried to shoot himself in bed but missed and fell out of bed so then called for EMS"
 
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A few from my collection:

"Scratched by puppy"

"BULL ATTACK"

3fer: "sick," "sick," "not sure if sick wants to check"

And my all time personal favorite:

"Out of dilaudid"
 
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IMG_20130518_035335_994.jpg
 
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Favorite EMS call: 45/M c/o fatigue after masturbating seven times in a row.

Paramedic Me to Patient: "Yeah man, I'd be feeling tired, too..."
 
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My personal favorite, even though I'm just a scribe:
"Box wrench stuck on penis"
He'd had it stuck for 5 days before coming in.

Urology had to get a power tool from the hardware store so they could cut it off.
 
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IMG_0668.jpg


This was too good not to screen shot.


Also had a pt come in a while ago for chest pain...with the name was Titsworth.

Multiple Medical Complaints are always gold too...you walk in and they're all tearful
 
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teeayejay said:
View attachment 204364

This was too good not to screen shot.


Also had a pt come in a while ago for chest pain...with the name was Titsworth.

Multiple Medical Complaints are always gold too...you walk in and they're all tearful
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A hypothetical name? Don't want the hippa suits to **** a brick and fine you.


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I worked as a tech in an inpatient psych unit before starting medical school and got the best CCs ever

Some that come to mind:
"Yall worrying about my OD too much"
"I want my mommy!!"
"Nobody believes I'm Jesus Christ"

There are plenty more I'm sure, ill have to post later when they come to mind
 
One from my EMS days: Respond non-emergent for a hangnail on a 13 y/o male. Turns out it was a mouse bite. Said patient caught the mouse at the barber shop and brought it to his grandmothers house, grandmother tells him to let it go. He does-in the house. He recaptures it by the tail and it promptly bites him. Why did he call 911? "I want a report so I can sue the barber shop!" Grandma then commences to whooping his butt as we cleared, we could hear her yelling all the way to the unit.
 
"I tried to catch a rat with a hot dog and it May have bit me"
 
In residency in the Peds ED,
"Seeing ghosts"
Kids came in and showed me pictures they'd taken with their cell phones that just showed a few shadows in a dimly lit room.


At current job,
"Possible alien encounter"
Nice old pe-paw came home from church and saw aliens having sex on his kitchen table. When they wouldn't leave, he called the police, who then called EMS.
 
Rendar5 said:
View attachment 204841 Nice and simple
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Reminds me of one I saw in a chart (maybe a repost)

Pt. calls for an ambulance because he's so drunk. Ambulance arrives to get him and he's sitting on the curb with a six pack. He asks if he can finish his beer before they leave.
 
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-70 y/o male :"I swallowed a pill and it got stuck in my throat and now it isn't there"
-...why are you here then?
-"It just never happened to me before"


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tux4 said:
-70 y/o male :"I swallowed a pill and it got stuck in my throat and now it isn't there"
-...why are you here then?
-"It just never happened to me before"
Click to expand...

"Well, I'm glad it's all better now. Just make sure you stop by the billing and registration desk on your way out."
 
tux4 said:
-70 y/o male :"I swallowed a pill and it got stuck in my throat and now it isn't there"
-...why are you here then?
-"It just never happened to me before"

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Click to expand...


This nonsense, all day long in Florida.
 
"Asked NYPD if they could give her some heroin"

The story gets better than that. Completely bonkers woman in her late 70's wearing the "dont let this person escape the ED" colored gown from a nearby ED where she clearly escaped from. She had an IV still in and was asking random passerby's (including the NYPD) if she could get some heroin to shoot into her IV. The sad part that sort of ties it all together is she had been diagnosed with some stage IV massively disseminated cancer recently and basically lost her mind and decided to just give in to her every pleasure and die in a ditch happy and full of drugs rather than wasting away in a facility.

We did eventually discharge her (without heroin) after a very very very long process with the psychiatrists to decide if she had capacity or not and whether self harm of this kind counts as suicidal ideation or very creative patient palliation.
 
DocEspana said:
"Asked NYPD if they could give her some heroin"

The story gets better than that. Completely bonkers woman in her late 70's wearing the "dont let this person escape the ED" colored gown from a nearby ED where she clearly escaped from. She had an IV still in and was asking random passerby's (including the NYPD) if she could get some heroin to shoot into her IV. The sad part that sort of ties it all together is she had been diagnosed with some stage IV massively disseminated cancer recently and basically lost her mind and decided to just give in to her every pleasure and die in a ditch happy and full of drugs rather than wasting away in a facility.

We did eventually discharge her (without heroin) after a very very very long process with the psychiatrists to decide if she had capacity or not and whether self harm of this kind counts as suicidal ideation or very creative patient palliation.
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That sounds like a really easy dispo, why was the process so long? Pt is obviously a danger to self and gravely disabled. Fill out the paperwork for emergency detention, admit to psych, and let them decide whether she can go home or not. I'd rather not be the person sending her home.
 
Zebra Hunter said:
That sounds like a really easy dispo, why was the process so long? Pt is obviously a danger to self and gravely disabled. Fill out the paperwork for emergency detention, admit to psych, and let them decide whether she can go home or not. I'd rather not be the person sending her home.
Click to expand...

Because it took a damn eternity for us to prove to our psychiatrists that she wasnt medically sick (you know.... with tumor everywhere) and suffering from organic delirium. And the longer she stayed the more well thought out and persistent her thoughts were. She just wanted to enjoy her remaining days high as a kite and was aware she might go to jail for it, but would probably either die during her hearing or be released due to compassionate release. Like... bizarrely aware of her situation, she just *really* wanted heroin. Really really. Grandma got a taste for it.

So then psych ER took something like a full 12 hours to mull it over in their unit and basically decided to let her go when she (and im not joking) promised to lay off the heroin for a bit.
 
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