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Haven't they heard of tylenol

Discussion in 'Emergency Medicine' started by ERMudPhud, Mar 28, 2004.

  1. ERMudPhud

    ERMudPhud Back for a visit
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    I guess I was in a bad mood but during my last overnight shift I started asking people what they had done at home to alleviate whatever minor complaint(viral URI's, sorethroats, aches and pains, stomach cramps, indigestion, etc...) had brought them to the ER in the middle of the night. As time went on I realized that most of them hadn't done ANYTHING. People didn't seem to even try motrin, tylenol, maalox, or mylanta before just packing up and heading to the ER. I started wondering why wouldn't you at least try something OTC before coming to the ER and I asked them exactly that question. Most had no answer and the ones that did just made me more grumpy. One lady actually had the nerve to say that she didn't like taking medication but then got mad when I wouldn't give her antibiotics for her viral pharyngitis. So I guess I'm still wondering why the hell don't they at least try tylenol or something before hauling themselves into the ER at 4:00 AM
     
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  3. docB

    docB Chronically painful
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    When I ask that question I usually get told that "Medicaid don't pay for no meds lessen you writes a scription for 'em."
     
  4. Apollyon

    Apollyon Screw the GST
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    The single historically most stupid patient encounter I've ever had (true story):

    Why are you here?

    I had a headache.

    Did you take anything for it?

    Yeah.

    Did it work?

    Yeah.

    Is the headache gone?

    Yeah.

    So why are you here?

    Because I had a headache.


    I feel your pain - every day.
     
  5. Freeeedom!

    Freeeedom! Senior Member
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    My favorite...

    Me: Hello mam how are you
    Her: ok

    Me: what brings you to (hospital X) tonight by ambulance
    Her: I had a headache
    Me: have you ever had a headache like this before
    Her: yeah when I was pregnant
    Me: Are you asking me for a pregancy test?
    Her: yes, I just want to know if I am pregnant.

    Me (in my head) : you worthless piece of unemployed sh!t, how dare you take an ambulance ride for a friggin pregnancy test...who the hell would want to stick their (blank, blank, blank) in you anyway!
     
  6. DrQuinn

    DrQuinn My name is Neo
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    My motto... for every pig, there's a pig fuc*er.

    Q, DO
     
  7. DrQuinn

    DrQuinn My name is Neo
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    I think our ER (Tampa General Hospital) used to be like that... but i think our # of recurring "regulars" has decreased. One of my colleagues gave a regular a DRE and we haven't seen that patient since!

    Q, DO
     
  8. blotto geltaco

    blotto geltaco Old-timer
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    My Favorite:

    Hx: Smoked some dope
    C/C "I feel funny"

    I would too.
     
  9. beanbean

    beanbean 1K Member
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    Last night - EMS call:

    CC: Vomiting 'blood' and nausea

    Hx: Drank a bottle of RED wine to celebrate her birthday

    Any chance that could be RED wine you have been throwing up ???? Any chance that nausea could be from drinking an entire bottle of RED wine?????

    The good thing about going through life without any common sense is that you don't have the common sense to realize what you are missing.

    Insisted on ambulance ride to the ED
     
  10. Kalel

    Kalel Membership Revoked
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    I got an "urgent" page on the floor because a patient who I was cross covering for was vomiting "large amounts of blood". I arrived by her bedside and see her calmly watching TV with a tub full of red liquid next to her bed. I asked her what she had been eating, and she told me red jello. I checked a heme card on the red stuff anyways, just in case, and it was negative. People should always take a recent diet history before they assume that everything red is blood.

    Regarding the patients showing up at inopportune times, I definitely know the feeling. When I was working in the ER, we frequently had patients come in from 1-6 AM for management of their "chronic" issues. One time, an ER resident told me that she asked a patient why the patient had decided that their chronic foot pain that had been going on for the last 3 months needed to be addressed at 3 AM in the morning, and the patient responded that she figured that the ER wouldn't have anything else to do. :rolleyes: The doctor who came up with the idea of triage and making part of the ER urgent care is a genius, these types of patients tend to clog up the system so that those who need to be seen aren't seen in a timely manner. All ER's should have signs saying "This is an EMERGENCY room, not a 24 hr clinic. If it can wait, you shouldn't be here."
     
  11. ERMudPhud

    ERMudPhud Back for a visit
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    Friday night 3:00 A.M. raging spring snowstorm blowing outside

    CC: I can't sleep because I have a bad cold

    Mode of arrival: Bicycle


    I actually said after taking the history, "please tell me there is some other reason you are here because nobody in their right mind rides a bicycle through a raging snowstorm at 3:00 AM to get seen in the ER for a cold"
     
  12. beyond all hope

    beyond all hope Senior Member
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    Last night, arrived by paramedics 'for feeling sick' x1d. 30 second history and physical showed heroin addict in mild withdrawl b/c no methodone this morning. Pt walked out to triage, as soon as he realized he wasn't staying in the ER started screaming and cussing and walked out.

    20 minutes later, same patient called 911 and is back on the paramedic gurney. 5 minutes after that, walked to triage. Curses and walks out again.

    Probably called an ambulance that took him to a different hospital.
     
  13. emedpa

    emedpa GlobalDoc
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    Large Trauma Center With Em Residency
    Problem #1 Too Many Pts Faking Migraines To Get Narcs
    Problem #2 Residents Not Doing Enough Lp's
    Solution To Both(true Story) Every Pt In Er With H/a Gets Lp Every Time Even If They Come Back The Next Day.......
    Result: Drastic Decline In Drug Seeking Pts With H/a At This Hospital...they All Developed Back Pain And Dental Pain.....
     
  14. mikecwru

    mikecwru M.D. = Massive Debt
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    Best quote of the day: "If you can sit in the ER waiting room, then you really shouldn't be in the ER in the first place."

    mike
     
  15. trauma_junky

    trauma_junky 12 step pre-med rehab
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    Take this advice from a current paramedic and future MD, "The BS factor of a call increases exponentially with the number of fully functioning cars in the driveway!" ..."Yes senior, you have a hang over. Yes, that is why your head hurts. If you want to go to the hospital you can call a cab or get your lazy wife off her ass and take you to the hospital in one of the 6 cars in your driveway, but your not riding in that bus you see right there." ..."Yes you're supposed to have puss comming out of that "spider bite". Ya, what they did yesterday at the ER is called an I&D, it lets the wound drain and heal properly. No, your leg is not falling off. That 66 Impala looks great does it run? 9.0 sec quarter mile huh! Well the hospital is 3 miles down the road so you can make it here in 108 seconds if you catch all the lights!" ..."Let me get this straight, you're son has frontal lobe dammage and you don't give him his meds because you don't feel like it and now he is destroying your house like an Ape on PCP. Screw it, go pull up some Etomidate!"
     
  16. trauma_junky

    trauma_junky 12 step pre-med rehab
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    I got a call at a nursing home once for a patient that had "coffee ground emesis." The only thing wrong was it smelled like sh!t, litteraly. I explained to the nursing home staff that prolonged peg tub feedings with out enough saline flushing leads to Bowl obstruction and the patinet was vomiting fecal matter not digested blood. Their faces were as white as sheets after I told them that. LOL! :smuggrin:
     
  17. beyond all hope

    beyond all hope Senior Member
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    Great idea but most drug-seekers realize that they can refuse an LP. Believe me I've tried it. Besides, I never use narcotics for migraines - even EBM says it's a bad idea.

    I tell all drug seekers up front "I'm not going to give you morphine or demerol because (bull**** medically-realistic sounding reason)". Non-confrontational, friendly, but resolute. The seekers usually leave screaming obsenities, and the non-drug seekers say. "Okay, whatever you need to do, just take care of my pain doctor." If they're still around a few minutes later, they get whatever opiates are indicated.
     
  18. Sessamoid

    Sessamoid 1K Member
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    Not defending him, but the likely reasons was nasal congestion. It's kinda hard to sleep with your nose completely clogged up, if you're not used to it. I've been fighting a bad cold for 5 days now, but at least I have steroid nasal sprays.
     
  19. cooldreams

    cooldreams American Mensa Member :)
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    lol u guys are freakin cool... i wanna be an er doc now heheheh
     
  20. cooldreams

    cooldreams American Mensa Member :)
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    dood!!! i just got bad karma for saying that above!!! wut the heck... i was serious... i think you guys ARE cool.... sheesh... :confused:
     
  21. Seaglass

    Seaglass Quantum Member
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    don't freak out, I think some people are just going karma crazy now that we have such a thing. It's like crack, you can never match the first high of giving out bad karma but you try. I'll give you some good karma to even it out.

    Interestingly the designers of this forum apparently don't know that in hinduism/buddhism the goal is to GET RID of karma, not accumulate good karma (although good is preferable to bad karma).

    C
     
  22. Pilot

    Pilot Senior Member
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    I good karma'd you also. Enjoy. :cool:
     
  23. cooldreams

    cooldreams American Mensa Member :)
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    thx guys... its appreciated hehe
     
  24. trauma_junky

    trauma_junky 12 step pre-med rehab
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    MAybe they are trying to tell you not to go into ER, hehe.
     
  25. cooldreams

    cooldreams American Mensa Member :)
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    maaaaaaaaybe... .... or maybe they are daring me to... a challenge, a dual, what have you. i accept, bring it on.... i will take on anyone... lez rock yo... hehehe :laugh:
     
  26. Tazmaniac

    Tazmaniac 2 min. from a nice nap
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    My personal favorite is the anxious mother who thinks the otherwise peacefully sleeping kid has a fever at 4am without a thermometer. :idea: :luck:
     
  27. Katee80

    Katee80 Senior Member
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    I've noticed that in many of the posts I've read, this dialect (for lack of a better word) is prevalent throughout the board. Do people actually talk like this or are you exaggerating? :D ........eh?
     
  28. Apollyon

    Apollyon Screw the GST
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    No exaggeration...at all.
     
  29. basementbeastie

    basementbeastie Senior Member
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    in fact, i would call it an understatement...easier to read text on the computer than to interpret live....dialect.
     
  30. lloydchristmas

    lloydchristmas Senior Member
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    Exactly. Most of them make Joe Dirt look like a member of the royal family. ER sucks no matter how you look at it. I wouldn't care why they came in if I didn't have to pay for it. Or at least they could be forced to pay a $20 copay or something.

    I truly wish I could say to these people what I really want to when they come in pre-diagnosed with "ammonia". GRRRRRRR
     
  31. One of my favs from my days as a lowly ER orderly:
    Patient revealed to the resident during the H&P that when he was 25 he had "MightyJesus" - Menigitis for those not well versed in such elegant vernacular.
     
  32. joaquin13

    joaquin13 Senior Member
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    I used to work taking 911 calls...which is the most abused system on Earth. People call 911 at 2 am for low back pain. When asked when it started...they answer 6 months ago. Or they call for cough, runny nose, you name it, and they need an ambulance NOW! My personal favorite:
    A teenage couple called 911 at 10 pm one night demanding that the fire dept/paramedics be sent over to bring them the MORNING AFTER PILL!
     
  33. docB

    docB Chronically painful
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    I saw a woman today with a CC of foot pain. I examined her foot and she had a blister. She never even looked at her own foot to see that all she had was a blister. She just decided that her foot hurt too much to work so she came to the ER. ER visit for a stinkin' blister.
     

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