Haven't they heard of tylenol

ERMudPhud

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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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    Freeeedom!

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    I am a ninja
      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!
       

      DrQuinn

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        Originally posted by Freeeedom!
        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!

        My motto... for every pig, there's a pig fuc*er.

        Q, DO
         

        DrQuinn

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          Originally posted by Meza
          Our ER seems like an enormous clinic because we are a county facility and no one has the balls to tell chronic headaches and bs chest pain to go home after the 7th consecutive visit...

          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
           

          beanbean

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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
             

            Kalel

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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."
               

              ERMudPhud

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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"
                 

                beyond all hope

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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.
                   

                  Emedpa

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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.....
                     
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                    trauma_junky

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                      Freeeedom! said:
                      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!


                      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!"
                       

                      trauma_junky

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                        Kalel said:
                        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."

                        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:
                         

                        beyond all hope

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                          emedpa said:
                          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.....

                          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.
                           

                          Sessamoid

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                            ERMudPhud said:
                            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"
                            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.
                             

                            Seaglass

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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
                               

                              Katee80

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

                                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?
                                 

                                lloydchristmas

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                                  basementbeastie said:
                                  in fact, i would call it an understatement...easier to read text on the computer than to interpret live....dialect.

                                  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
                                   
                                  C

                                  CaptainZero

                                    lloydchristmas said:
                                    I truly wish I could say to these people what I really want to when they come in pre-diagnosed with "ammonia". GRRRRRRR
                                    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.
                                     

                                    joaquin13

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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!
                                       

                                      docB

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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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