Things I Learn From My Patients

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The guy with the five shots put one through each cheek, one out just behind his right eye, one out the bridge of his nose and then finally one that lodged in his parietal lobe. It was quite an interesting case.

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If you are going to come to the emergency department looking for drugs to treat your chronic migraine, do not claim that you are a police officer, flash an official police badge that is not yours (who knows how she got it...), and demand a prescription for Norco.

This is especially not very smart given that the doctor that you flash the badge to happens to be an ex-police officer. This doctor will proceed to call the police to let them know that there somebody in the emergency department flashing a police badge demanding narcotic medications. The police will come and arrest you for impersonating a police officer, and you will sit in jail thinking of new ways to obtain your Norco while you are getting butt raped by a large inmate (ah yes, Sublime song on my mind).
 
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If you have a 20 year history of uncontrolled diabetes and a severe case of peripheral neuropathy, it is probably not a good idea to sleep with your dog, even if it is only a chihuahua. It's gotta be a bit of a shock to wake up and see that the dog has gnawed off the tip of your big toe while you were napping, and you couldn't feel a thing.

That dog would be taking a long nap at the vet's office if it were my toe. :barf:

"Yo quiero Taco Bell!"
 
Not nearly as funny or downright insane as some of the others but here is one from an EMS ride I did today as part of an elective:

If you fall and hurt your hip really bad and you cannot move your leg which is rotated outward do not hesitate to have your husband call for help. It probably won't magically get better. Spending 13 hours on the floor of your house will not be comfortable especially when you need to use the restroom. I mean it would be one thing if you are alone and couldn't get to a phone but when your husband is able bodied and there for all of it maybe you should have him call for help long before 6 AM when you hurt it at 5 PM the night before.
 
One of my friends' mother did that. She told us (the EMT's) that she "didn't want to bother us for something so minor"....she ended up with renal failure from rhabdomyolysis from laying in one position for too long on top of an femur fracture.
 
You really shouldn’t keep your gorked out, diabetic, stroke riddled, end stage renal dialysis, infected, screaming in chronic pain wife alive indefinitely just so you can keep getting her pension checks. It means you’re going to Hell. And you’re making me come along with you.
 
docB said:
You really shouldn’t keep your gorked out, diabetic, stroke riddled, end stage renal dialysis, infected, screaming in chronic pain wife alive indefinitely just so you can keep getting her pension checks. It means you’re going to Hell. And you’re making me come along with you.
Wow, if Dante was right, he'd be sitting down on the bottom with Satan. :smuggrin:
 
Leviathan, I just have to say that your screen name and avatar combo is a subtle but nice touch. I didn't make the connection until just now.
 
Feel free to call EMS if you ever need a ride downtown. When you get to the emergency department, just complain loudly about the 4 hour wait and proceed to leave the hospital.
 
My dad (an emergency physician) saw this one:

If you have plans to take your girlfriend out to a really nice restaurant to propose and give the ring to the waiter with instructions to bring it in a glass of champagne towards the end of the meal- don't get drunk before it arrives, and if you do, at least remember that there's a ring in one of the glasses, so look it in closely before taking that swig!

He showed me the film- hilarious!
 
If you and your high school buddy are bored at 2 am on a Saturday the best way to kill a few hours is to break into the nearby Dentist Office and steal a tank of Nitrous Oxide.

When you manage to get it up to your bedroom, do NOT start inhaling it while standing up, you will get woozey fall over, and crack open your skull on the corner of your desk.

It is also okay to ask dispatch if the paramedics could "please not use the siren so it won't wake up my parents."
 
fenixwbp said:
If you and your high school buddy are bored at 2 am on a Saturday the best way to kill a few hours is to break into the nearby Dentist Office and steal a tank of Nitrous Oxide.

When you manage to get it up to your bedroom, do NOT start inhaling it while standing up, you will get woozey fall over, and crack open your skull on the corner of your desk.

It is also okay to ask dispatch if the paramedics could "please not use the siren so it won't wake up my parents."
The skull fracture(?) is nothing to spit on, but it's people like that who make me wish it was possible to OD on nitrous. :p
 
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Just got some follow up on this one:

When you return to the ED 3 weeks after you have recovered from your Ancef-allergy-causing cric with a new foot cellulitis and the doctor asks you if you have any allergies, you should probably not awnser "NO, no allergies"!
 
If the cops are investigating you for child care issues, do not let a drunk babysit your kids...

http://www.msnbc.msn.com/id/10634256/

That said, the idea of a drunk 2 year old is kind of funny, "The deputies also noticed the 2-year-old was having difficulty standing, had bloodshot eyes, smelled of alcohol and was lethargic." - Aww, nothing like an early start :laugh:!

- H
 
FoughtFyr said:
If the cops are investigating you for child care issues, do not let a drunk babysit your kids...

http://www.msnbc.msn.com/id/10634256/

That said, the idea of a drunk 2 year old is kind of funny, "The deputies also noticed the 2-year-old was having difficulty standing, had bloodshot eyes, smelled of alcohol and was lethargic." - Aww, nothing like an early start :laugh:!

- H
Very nice, and the reason why the baby sitter was there in the first place is even nicer...
 
When your dog bites you because "he likes [your] brother more than [you] when you drink," put down the bottle and get a new dog.
 
If you're looking for really strange fetish try this one:

My patient was sneaking into the women's restrooms when no one was around. He'd rummage through the garbage and get out dirty diapers, and used feminine hygenie products. He would then eat the feces, and put the tampons and pads in his mouth. He told me "I turns me on...sexually"

Fortunatly he realized that this was a problem, and wanted to stop, mostly because he didn't want "Hepatitis or something".
 
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EMRaiden said:
If you're looking for really strange fetish try this one:

My patient was sneaking into the women's restrooms when no one was around. He'd rummage through the garbage and get out dirty diapers, and used feminine hygenie products. He would then eat the feces, and put the tampons and pads in his mouth. He told me "I turns me on...sexually"

Fortunatly he realized that this was a problem, and wanted to stop, mostly because he didn't want "Hepatitis or something".

O.k., I honestly, after 15 years now in EM and EMS, did not actually think I could get grossed out anymore.

I was wrong.

:barf:

- H

BTW - you win the award for most disturbing SDN post EVER!
 
EMRaiden said:
If you're looking for really strange fetish try this one:

My patient was sneaking into the women's restrooms when no one was around. He'd rummage through the garbage and get out dirty diapers, and used feminine hygenie products. He would then eat the feces, and put the tampons and pads in his mouth. He told me "I turns me on...sexually"

Fortunatly he realized that this was a problem, and wanted to stop, mostly because he didn't want "Hepatitis or something".

Now I know what to look forward to! I'll see you next Monday!

Excellent!
 
If after a night of drinking you have trouble waking up your husband it's OK to gently shake him and say his name to try to arouse him. You shouldn't start punching him in the face repeatedly. If you do this you will likely wake him from his drunken stupor but his broken nose and zygomatic fracture will hurt for at least as long as it takes you to clear up the domestic battery investigation.
 
As an unrestrained driver, when attempting to shoo an angry bee out of the cab of your truck, it is generally advisable to keep at least one eye on the road so as to avoid crashing said truck into a tree which happens to be said bee's home where many other equally excitable bees live. 1 broken clavicle, several head lacs and 200+ stings later...
 
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EMRaiden said:
If you're looking for really strange fetish try this one:

My patient was sneaking into the women's restrooms when no one was around. He'd rummage through the garbage and get out dirty diapers, and used feminine hygenie products. He would then eat the feces, and put the tampons and pads in his mouth. He told me "I turns me on...sexually"

Fortunatly he realized that this was a problem, and wanted to stop, mostly because he didn't want "Hepatitis or something".


And he volunteered this info?.....Under duress right? RIGHT??? :eek:

Frikkin' barf me out man! :barf:

Katee
 
A_Dull_Boy said:
As an unrestrained driver, when attempting to shoo an angry bee out of the cab of your truck, it is generally advisable to keep at least one eye on the road so as to avoid crashing said truck into a tree which happens to be said bee's home where many other equally excitable bees live. 1 broken clavicle, several head lacs and 200+ stings later...


:laugh: Jeesh! we just can't make this stuff up can we? This was a good one ...
 
EMRaiden said:
If you're looking for really strange fetish try this one:

My patient was sneaking into the women's restrooms when no one was around. He'd rummage through the garbage and get out dirty diapers, and used feminine hygenie products. He would then eat the feces, and put the tampons and pads in his mouth. He told me "I turns me on...sexually"

Fortunatly he realized that this was a problem, and wanted to stop, mostly because he didn't want "Hepatitis or something".

Holy crap that is gross.
 
Wow. Really... wow.

Hmm... you know, they could make "House, MD" episodes out of this thread! :D
 
quideam said:
Wow. Really... wow.

Hmm... you know, they could make "House, MD" episodes out of this thread! :D

Hey it is clear that the stuff that happens in real life is much crazier than what anyone could come up with in a movie/show script.
 
I learned today that the fire department EMT's in the town where I work part time are not very good at keeping trauma patients from getting up and walking around after a serious wreck. I've also learned that they tend to crap themselves when the patient who just told the EMT "I'm fine, I'm just a little sore from the seatbelt" turns, grabs his chest and vomits :barf: bright red blood before collapsing. :wow: :eek: :scared:

The final thing I learned that the courtesy of letting the responding ambulance crew know that the patient just coded eludes them. They learned that this is one of my pet peeves. +pissed+ :smuggrin:
 
Praetorian said:
Yes, the blue one was the first shot. The second one effectively emptied his skull out. The first shot was effective in only rendering an open casket service not an option. At least the kid had the decency to finish the job.

BTW, I'm trying to get copies of the 3D CT reconstructs of his skull post shot (our pathologist has a fetish for these types of images on all head traumas) and if I can, I'll share them as a teaching case. :thumbup:
what kind of teachable moment is there on a guy with no head? For that matter... why even transport? In the county i worked in, we would just pronounce him there, and let the coroner deal with it - no reason to take an ambulance off the street for a dead body.
 
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We didn't transport him in an ambulance....I work doing removals for a funeral home (in addition to EMS) and we remove coroners cases from time to time.
 
I couldn't resist sharing this after reading through all thirty some pages.

Hopefully, you won't much care that I'm not a med student of any sort , but I do know basic first aid and can generally tell if something can wait until morning or requires a trip to the ER.

I thought that some of you would get a kick out of these two:

This one happened about four years ago to my now husband and myself, at the time we were just dating.

I'm sure the ER staff had a bit of an eye roll at his expense, actually, I know they did because I shared it with them.

Now, the story. *ahem*

Before I start, I want to point out that we were both SOBER when this happened. No alcohol was involved, just, I think, machismo on my husband's part. ;)

When you're out for a late night motorcycle ride with your girlfriend and take a sandy corner a bit too fast and end up in a ditch that has a nearly 60 degree incline that is covered with long, wet grass, by all means don't listen to your girlfriend when she says, "Just roll the bike into the yard that's about five feet through the tall grass that way, it's flat, we can get back onto the road and go home." (We didn't flip over, and were only going about 20 at the time so we sort of gracefully glided down into the ditch)
Also, ignore her suggestion of rolling it through the bottom of the ditch to the end of said ditch at the crossroads and getting it back up onto the road that way as there is only a short, slight incline (like that of a speed bump) that way.

PLEASE insist that you can drag a 450lb or so bike up the slippery, wet, grassy embankment and back onto the road because you "don't want to tresspass."
Insist that she's worrying too much when she says, "That's stupid, you'll throw your back out or worse, and no I'm not going to push it from behind. If you lose your grip it will FALL ON ME."
Keep trying to tug the bike out of the ditch, despite her repeatedly telling you to roll it across the flat yard and back onto the road until someone drives by, asks why you haven't listened to her, but proceeds to help you pull the bike up the wet, grassy, steep little embankment.

Swear you're all right even, and ride home without incident even though you tell her that she can't hold onto you as usual because "your chest hurts."

Ignore your girlfriend's "Maybe I should drive you to the ER, you're white as a sheet, clammy, sweaty, not really coherent, and I think you may have done more than just hurt your back." suggestion, as she's clearly a worrying mother hen and is overreacting.

Use hard, frozen meat as a "compress" on your ribs and never mind the fact that you can't do more than shallow gasping without wincing (and forget the fact that you're a two pack a day smoker so, yeah, shallow gasping probably doesn't help much). Ignore your girlfriend when she says, "It's not your asthma, your inhaler isn't going to help."
Ignore the fact that you can't barely move without passing out due to pain.

ONLY consent to letting your girlfriend drive you to the ER when she threatens to call 911 if you don't.
In the car, freak her out by drifting in and out of consciousness, muttering that you're 'cold' (when it's 90 degrees outside), and making her wonder if she's going to have to stop the car, call 911 on her cell, and make sure you don't stop breathing or pass out. Again.

Once in the ER, claim you're feeling better even though you can't remember ANY of your info to give to the poor nurse.
Forget that you have lethal or near lethal allergies to anything related to penicillin, that aspirin and its related friends make your stomach bleed rather uncontrollably, that you're allergic to whatever the hell is used in neosporin, and that ibuprofin makes your kidneys feel like they're being punched and has the added bonus of making you have bloody urine! Forget that you're a smoker and asthmatic.
Just say 'no' when the nurse asks and make your girlfriend have to jump in with that information.
Explain to the doctor who sees you that you think that your girlfriend is overreacting even though you can't clearly explain what happened other than it involved a motorcycle and that you can't move without hitting 10 on the pretty little sliding scale of smiley faces on the wall.

When the x-rays come back to show about five cracked ribs (three on the left, two on the right!), and other scans done (it's been way too long, I forget everything that was done) show several torn muscles around your chest, back and shoulders, and you're given an rx for relaxants, painkillers, and referrals to specialists and for physical therapy, smiling sheepishly and accepting the, "I told you so" from your girlfriend was appreciated though. ;)

And yes, your girlfriend will force you to go through with it. Every appointment, and the at home exercises, she will force you to 'take it easy' and will not consider any around the house work you think you need to do as 'taking it easy' (such as, oil changes on cars, heavy yard work, tree branch pruning, fixing a leaky sink, shampooing the carpets, etc..) and years later she will never EVER let you live it down.
It's been a bit of a running joke for us.


AND just to make it fair, I may as well post one of my own dumb moves:

It takes a LOT to get me to go to just a regular doctor, and even more to get me to go to urgent care or the ER.
I have to either have something obviously broken or be quite convinced that I'm actually very, very sick or injured, and even then I may put it off for a day or two to "just wait and see."

The fact that you're so weak that you can barely move, can't speak, have trouble staying awake, can't swallow much of anything, and your throat is so swollen that it's nearly closed (and covered with white discs that sometimes come off when you cough) is no reason to see a medical professional.
It's just a sore throat, not strep.
It will pass and not spread to any other parts of your body, like your sinuses or your lungs (forget the fact that this is how your paternal grandfather DIED back in '85, though to be fair, it hit his kidneys, brain, liver and heart lining AND he was close to 70 at the time so he was much worse off than I).
It won't get so bad that when you finally do drag your sorry, pasty, fairly dehydrated, half corpse into the hospital the nurse who sees you walk in won't visibly step back then ask if you need a wheelchair, and people won't instinctively scoot away from you so as not to catch whatever plague you've got.
It won't cause the poor doctor who sees you to almost *jawdrop* and ask you how long this has been going on.
It won't cause him to "interrupt" your writing of what's been happening with, "You drove YOURSELF here?!"
He'll be happy to hear it's been almost a month and has been getting worse and worse, really!
And he'll LOVE the reasoning of, "Yeah, well, I'm not one to run to the doctor over every sniffle" in this case (keep in mind, I can't talk, so I'm WRITING responses to what he's asking me if it's not yes/no).
He'll be even HAPPIER to hear that you continued to go to work up until the point that you lost your voice, thus probably spreading strep to the entire office. YAY!
He will, however, laugh a bit when you write, "Strep? That bad? F*** plain penicillin, give me Augmentin. Liquid, please." after he tells you that it is, indeed, a very bad case of strep throat.
It had spread up into my sinuses and had made a move toward the ol' lungs. So many antibiotics and I was still laid up for a good week before I could go back to work.
 
Just because you're a chiropractor, doesn't mean you can fix horses. This guy had most of his fingers mangled by a horse hoof while adjusting the atlas. Apparently it's a VERY good paying job though, the fiance had a 3 ct ring on!
 
RPW said:
I just got throught reading a book by an ER doc written in the 70's it was called Breath, Little boy, Breath.

Really a good book with lots of funny stories in it but I cant remember who the author is.

Here it is <a href="http://www.amazon.com/gp/product/0130817295/qid=1138751805/sr=1-1/ref=sr_1_1/104-2393575-0867159?s=books&v=glance&n=283155"> on Amazon</a>. It looks like it's been out of print for a while.
 
Way too much for me to read. :eek:

wolfytech said:
I couldn't resist sharing this after reading through all thirty some pages.

Hopefully, you won't much care that I'm not a med student of any sort , but I do know basic first aid and can generally tell if something can wait until morning or requires a trip to the ER.

I thought that some of you would get a kick out of these two:

This one happened about four years ago to my now husband and myself, at the time we were just dating.

I'm sure the ER staff had a bit of an eye roll at his expense, actually, I know they did because I shared it with them.

Now, the story. *ahem*

Before I start, I want to point out that we were both SOBER when this happened. No alcohol was involved, just, I think, machismo on my husband's part. ;)

When you're out for a late night motorcycle ride with your girlfriend and take a sandy corner a bit too fast and end up in a ditch that has a nearly 60 degree incline that is covered with long, wet grass, by all means don't listen to your girlfriend when she says, "Just roll the bike into the yard that's about five feet through the tall grass that way, it's flat, we can get back onto the road and go home." (We didn't flip over, and were only going about 20 at the time so we sort of gracefully glided down into the ditch)
Also, ignore her suggestion of rolling it through the bottom of the ditch to the end of said ditch at the crossroads and getting it back up onto the road that way as there is only a short, slight incline (like that of a speed bump) that way.

PLEASE insist that you can drag a 450lb or so bike up the slippery, wet, grassy embankment and back onto the road because you "don't want to tresspass."
Insist that she's worrying too much when she says, "That's stupid, you'll throw your back out or worse, and no I'm not going to push it from behind. If you lose your grip it will FALL ON ME."
Keep trying to tug the bike out of the ditch, despite her repeatedly telling you to roll it across the flat yard and back onto the road until someone drives by, asks why you haven't listened to her, but proceeds to help you pull the bike up the wet, grassy, steep little embankment.

Swear you're all right even, and ride home without incident even though you tell her that she can't hold onto you as usual because "your chest hurts."

Ignore your girlfriend's "Maybe I should drive you to the ER, you're white as a sheet, clammy, sweaty, not really coherent, and I think you may have done more than just hurt your back." suggestion, as she's clearly a worrying mother hen and is overreacting.

Use hard, frozen meat as a "compress" on your ribs and never mind the fact that you can't do more than shallow gasping without wincing (and forget the fact that you're a two pack a day smoker so, yeah, shallow gasping probably doesn't help much). Ignore your girlfriend when she says, "It's not your asthma, your inhaler isn't going to help."
Ignore the fact that you can't barely move without passing out due to pain.

ONLY consent to letting your girlfriend drive you to the ER when she threatens to call 911 if you don't.
In the car, freak her out by drifting in and out of consciousness, muttering that you're 'cold' (when it's 90 degrees outside), and making her wonder if she's going to have to stop the car, call 911 on her cell, and make sure you don't stop breathing or pass out. Again.

Once in the ER, claim you're feeling better even though you can't remember ANY of your info to give to the poor nurse.
Forget that you have lethal or near lethal allergies to anything related to penicillin, that aspirin and its related friends make your stomach bleed rather uncontrollably, that you're allergic to whatever the hell is used in neosporin, and that ibuprofin makes your kidneys feel like they're being punched and has the added bonus of making you have bloody urine! Forget that you're a smoker and asthmatic.
Just say 'no' when the nurse asks and make your girlfriend have to jump in with that information.
Explain to the doctor who sees you that you think that your girlfriend is overreacting even though you can't clearly explain what happened other than it involved a motorcycle and that you can't move without hitting 10 on the pretty little sliding scale of smiley faces on the wall.

When the x-rays come back to show about five cracked ribs (three on the left, two on the right!), and other scans done (it's been way too long, I forget everything that was done) show several torn muscles around your chest, back and shoulders, and you're given an rx for relaxants, painkillers, and referrals to specialists and for physical therapy, smiling sheepishly and accepting the, "I told you so" from your girlfriend was appreciated though. ;)

And yes, your girlfriend will force you to go through with it. Every appointment, and the at home exercises, she will force you to 'take it easy' and will not consider any around the house work you think you need to do as 'taking it easy' (such as, oil changes on cars, heavy yard work, tree branch pruning, fixing a leaky sink, shampooing the carpets, etc..) and years later she will never EVER let you live it down.
It's been a bit of a running joke for us.


AND just to make it fair, I may as well post one of my own dumb moves:

It takes a LOT to get me to go to just a regular doctor, and even more to get me to go to urgent care or the ER.
I have to either have something obviously broken or be quite convinced that I'm actually very, very sick or injured, and even then I may put it off for a day or two to "just wait and see."

The fact that you're so weak that you can barely move, can't speak, have trouble staying awake, can't swallow much of anything, and your throat is so swollen that it's nearly closed (and covered with white discs that sometimes come off when you cough) is no reason to see a medical professional.
It's just a sore throat, not strep.
It will pass and not spread to any other parts of your body, like your sinuses or your lungs (forget the fact that this is how your paternal grandfather DIED back in '85, though to be fair, it hit his kidneys, brain, liver and heart lining AND he was close to 70 at the time so he was much worse off than I).
It won't get so bad that when you finally do drag your sorry, pasty, fairly dehydrated, half corpse into the hospital the nurse who sees you walk in won't visibly step back then ask if you need a wheelchair, and people won't instinctively scoot away from you so as not to catch whatever plague you've got.
It won't cause the poor doctor who sees you to almost *jawdrop* and ask you how long this has been going on.
It won't cause him to "interrupt" your writing of what's been happening with, "You drove YOURSELF here?!"
He'll be happy to hear it's been almost a month and has been getting worse and worse, really!
And he'll LOVE the reasoning of, "Yeah, well, I'm not one to run to the doctor over every sniffle" in this case (keep in mind, I can't talk, so I'm WRITING responses to what he's asking me if it's not yes/no).
He'll be even HAPPIER to hear that you continued to go to work up until the point that you lost your voice, thus probably spreading strep to the entire office. YAY!
He will, however, laugh a bit when you write, "Strep? That bad? F*** plain penicillin, give me Augmentin. Liquid, please." after he tells you that it is, indeed, a very bad case of strep throat.
It had spread up into my sinuses and had made a move toward the ol' lungs. So many antibiotics and I was still laid up for a good week before I could go back to work.
 
AR1776 said:
Just because you're a chiropractor, doesn't mean you can fix horses. This guy had most of his fingers mangled by a horse hoof while adjusting the atlas. Apparently it's a VERY good paying job though, the fiance had a 3 ct ring on!
Ah. Something I learned from not-a-patient.

I know someone whose partner is frustrated and annoyed, because this person's income is curtailed by a "stupid" state law. See, you can be a chiro for people, or you can be one for pets, but the licensing agency won't let you do both concurrently. Just another way The Man gets you down, I guess.
 
Hey folks, just got directed here by a friend specifically BECAUSE of this thread. Not a doc, no longer in EMS, spent 8 years after getting out of the Army as an EMT in Seattle and K.C.

Only wanted to post to comment on two things that seemed to be widely held ideas by other posters. The first being the sense of amazement at the "dedication" required of an attempted suicide to shoot themselves multiple times in quick succession, apparantly due to the idea of the pain the "victim" must be suffering after the first shot.

I've been shot several times (mostly military incidents, but two were of the "self-inflicted wound" category), in 6 seperate incidents. Three military incidents, a mugging, a malfunctioning "hammerless" semi-auto pistol that discharged unexpectedly, and a stupidity related accident when I decided to poach a wild turkey while hunting deer in MO brushland during shotgun season. Only the shotgun case (which was about half a 3" shell worth of #4 game load reflected back at me from a galvanized steel washtub concealed under the bush the turkey had run under when I moved...I was too hyped up at the idea of fresh wild turkey for dinner to think about the "don't shoot at what you can't see" rule grandad had apparantly not as sufficiently drummed into me as he and I thought) actually had any sensation of pain right off...EVERY other incident, I felt nothing I'd consider to be "pain" for at least 15 minutes, and this is with three of those incidents including intrusive fx...full speed bullets at effective range that haven't been slowed by riccochet or passing through other objects happen "too fast to hurt" until the immediate shock-trauma wears off, it seems (shrapnel, on the other hand, hurts worse than anything else I've ever experienced, and hurts right off the bat).


So take that into consideration when thinking about such cases (also when reflecting on the gang bangers ability to handle gunshot wounds but not needles...pure flesh wounds take even longer to actually start hurting, and never hurt more than a serious burn, IME. I'd assume penetrating AB wounds might be a different story).



The other thing was a story of my own you might appreciate in here regarding an ED visit a buddy of mine had to make. The guy was a professional roofer, foreman of a crew, took a side job, and got me, and another friend to fill in for two of his regular guys who were uninterested in giving up their weekend for extra cash. The roof was a fairly steep cedar shake piece with lots of hips and vallies. To save time, he locked back the blade guard on his circular, and was cutting the valley pieces, three at a time, holding them across his thigh, with the blade fully extended. This was after lunch, when he'd enjoyed a couple beers during his lunch (in summer, in a roof, in Kansas City, 95+F with 90%+ humidity). Sure enough, someone stepped on the cord at just the wrong time, while he was ripping the shingles, and the blade transversed his thigh diagonally, deep enough to make about a 1/4 inch groove in his femur. Additional damages from tying off with a rope around his middle, instead of wearing a harness, sliding down that level of roof, falling off the dormer (hooking the rope on it), then being stopped short of hitting the first floor roof level under the dormer (between the rope hooking on the dormer and him having wrapped a length around his arm in the process of trying to get a grip on SOMETHING to stop his fall).


Of course, since THIS wouldn't be covered by workman's comp, *******'s FIRST reaction is to ask the rest of us if we couldn't just pack the wound REALLY well, so he could fake like it had happend on the legit job Monday (this was Saturday), so he'd becovered by the company's insurance, and get paid time off to heal. Since it couldn't...and the ED attending wouldn't help him cover it up "for a couple days", he then tried to talk them into just doing a "soft cast", or "better yet, just wrap the screwed up arm in an ACE bandage, and stitch up the leg", so he'd be able to go to work Monday (I'm sure he was scheming to try and pawn it off on Worker's Comp, despite the collective lack of cooperation he faced)...when he was denied even THAT concession, he got abusive...upshot was, he threatened to leave AMA without waiting for sutures, "making do" with the bandages ED had replaced while waiting on ortho consult before proceeeding, was told that due to admitting having been drinking less than an hour previous, and having been given painkillers by EMS before THEY found that out, he wasn't competent to make that decision, and he ended up in hard restraint with KCPD standing over him while he was worked on. (Waiting so they could haul him off on assault charges resulting from his attempt to bull his way through when he first saw the uniforms while MD said he couldn't leave...St Joe's, KC, MO is a nasty enough area that uniform KCPD serves as about 2/3 of their security staff, it seems)
 
I went to college in south KC--graduated 20 years ago and moved to Vegas in 2003. I can see this happening at St. Joes, though. The south side of town was really going downhill when I was there, and it obviously hasn't gotten any better.

Great story--sounds like the idiot got what was coming to him!!
 
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Lesson for the unwashed: If you shoot yourself in the left anterior chest attempting suicide with a shotgun, your incessant whining that we're pulling out your precious chest hair while we peel off the silk tape to inspect your wound will be met with limited sympathy.
 
Chartres said:
Some of these stories seem really callous...

Try working in a jail where healthcare includes digging from the flesh of the homeless the jail socks they were given when released 4 months ago, which have since rotted literally in to their feet. Then there's the guy covered in sores with blood under his nails who insists on punctuating every point by touching your arm. Mmmm, MRSA.

Don't even get me started on the injured folks arrested each Thanksgiving.
 
This thread is getting some new life.. I like it.. post away,... please; for us!!!
 
(I had a woman who was tweaking on meth and handcuffed to the gurney pull a crack pipe out of her vagina AND EAT IT! She chewed it up and got glass in her mouth and esophagus. I'd never seen anyone eat a crack pipe before and I did med school in Philly )

Reminds me of a recent patient who was having difficulty breathing, she had a large stoma for years secondary to CA and an unidentifiable object on her CXR. She continued to desat and ended up, long story short, in the OR where a crack pipe was found in her R mainstem on bronchoscopy.
"Now how did THAT get there?!"
 
lytesnsyrens said:
or speaker wires. That really isn't a good idea.

..and no matter how much fun it sounds, try to avoid shoving a toothbrush, bristles first, into your urethra. You will dribble urine all over the ER and the docs caring for you will likely be low on sympathy..
 
nursevegas said:
I went to college in south KC--graduated 20 years ago and moved to Vegas in 2003. I can see this happening at St. Joes, though. The south side of town was really going downhill when I was there, and it obviously hasn't gotten any better.

Great story--sounds like the idiot got what was coming to him!!



I was last there in '98, and it depended on which side of State Line Road you were on, then...the MO side was getting trashy and dangerous almost down to Holmes (middle class neighborhoods sliding quickly downhill) while the KS side became more affluent. This particular incident was back in '92, though.
 
just because you find a girl who is drunk with DSL's at the moment, does NOT mean she's ready to be taken advantage of

you have clearly mistaken a girl who just got her wisdom teeth pulled

don't make the same mistake an acquaintance of mine did...

man, aren't most girls too embarassed to leave their homes when they go thru stuff like this these days?

i'm gonna go puke, brb
 
Important thing to remember:

About a year after you've had your legs burned off because you passed out next to a fire, be sure not to pass out while smoking in your wheelchair. Full-thickness burns to the buttocks, scrotum, leg-stumps, and back are going to ruin any future underwear modeling gigs.

Although, this guy did this two days after I spent a long time stitching up a huge head lac (he was drunk--surprise--and fell out of his wheelchair), at least he had the courtesy to avoid further head trauma. My work wasn't in vain.
 
xaelia said:
Lesson for the unwashed: If you shoot yourself in the left anterior chest attempting suicide with a shotgun, your incessant whining that we're pulling out your precious chest hair while we peel off the silk tape to inspect your wound will be met with limited sympathy.


Reminds me of a 16-year-old I took care of many years ago, admitted to the ICU with her THIRD self-inflicted GSW to the chest. Patient teaching--IMPROVE YOUR AIM so we don't have to deal with you!
 
steatopygia said:
(I had a woman who was tweaking on meth and handcuffed to the gurney pull a crack pipe out of her vagina AND EAT IT! She chewed it up and got glass in her mouth and esophagus. I'd never seen anyone eat a crack pipe before and I did med school in Philly )

Reminds me of a recent patient who was having difficulty breathing, she had a large stoma for years secondary to CA and an unidentifiable object on her CXR. She continued to desat and ended up, long story short, in the OR where a crack pipe was found in her R mainstem on bronchoscopy.
"Now how did THAT get there?!"
holy ^$#@! thats insane :eek:
 
Anytime a patient comes in by ambulance, their reason for calling 911 is written at the top of the ambulance form. I have collected my favorites over the past year; (these are most poignant when placed in the right context- first, ambulances are really expensive and our patients very rarely pay for it, second, imagine you haven’t seen your friends in weeks, you’ve been working hours on end, your starving, your feet hurt, it is 4am, and this will be your next patient…)
-“it is too cold outside”
-“there is Jesus inside of me”
-“F**k you”
-“my mascara is bothering me”
-“I cant sleep”
-“I feel unsteady after drinking”
-“I don’t want to go to the hospital”
-“I have pain in my fluffies” (this meant breasts)
-“my hand itches”
-“I am wet from the rain”
-“my throat feels dry”
(at times the ambulance crew will add the duration of the patients symptoms, which makes them even more enjoyable)
-“I have itchy skin” x 13 years
-“I have not bathed in 3 years”
-“the condom broke inside me” x 4 weeks
-“my stomach hurt” one week ago
 
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gotta spread the love.

1. If you're a team doctor and one of the football players (that would be me) tells you that the 300 pound center sat on his foot and then felt and heard a bone in his foot go pop, spend 20 minutes convincing said player that its just a strained ligament, "we have spare crutches, but you won't need them, we'll just tape it up a bit." Clearly this 17 year old that spends hours a day slamming into other people and is currently riding so much adrenaline he's cracking jokes about his busted foot, would be wimpering if it was actually broken. After the player tells you that "it's not a ligament, its effing broke" concede that if it still hurts in a couple days maybe he should get it xrayed. The next day act baffled that the player is pissed off at you when he comes to get a cast on it, after he woke up that morning, tried to get out of bed and collapsed on the floor screaming.

2. If someone (teammate) dislocates a shoulder wait until you get to a hospital 45 minutes away to pop it back in. Refuse all attempts to knock it back in place. Clearly all the coaches and players that have gone through it before know less than a parttime LPN. And besides the 45 minutes of gruesome agony will do the tightend some good.


3. If you're a trainer and a player comes to you at halftime complaining about a hurt forearm ask him to squeeze your finger (is this some kind of physical therapy joke I'm not in on?) and then tape his arm. When the player explains that it happened when he made a tackle with his arm between the legs of the running back, "like a twig in the spokes of a bicycle", counter with "probably just a bruise from a helmet... or something." Before next weeks game be sure to tape up that arm real good, after all its 10 times the size as the other one and beet red.

2 months later the swelling goes down and the forearm has a noticeable bulge in it. Now is the time for a physician to tell the patient to get it xrayed even though its still probably just a bone bruise.

When the patient comes in to pick up his xrays laugh hysterically at him and hold them up to the light so everyone in reception can see the triangle his radius and ulna make. Be sure to point out the centimeter gap in the ulna that has partially healed.

Now armed with xrays, it is time for the physician to refer the patient to a $1000/hr specialist 90 minutes away now that the injury doesn't hurt at all.
If you're that specialist take a look at the xray then chuckle softly. Crack a joke about rebreaking it again if the patient wants it fixed so you get to chuckle loudly. Then procede to tell the patient what they've already figured out: it would have been nice if it had been diagnosed 2 months earlier but since its mostly in one (bent) piece it'll have to do.

If your the team doctor or trainer that has effed up the diagnosis of either the foot or the arm, scold said injured player at the last game of the season and his career about taking 3 aspirin instead of 2. Chock it up to roid rage when the player tells you to go **** yourself.


4. One more, non-sports related:
When you go in to see a patient with a gash in the knee look it over a bit and then say, "a bandage should do it .... hmm ...the nurse already got out the sutures? Well I guess we're going to give you some stitches then." This builds the patient's confidence in your medical judgment and abilities.

Nothing personal, but I hate doctors.
 
gotta spread the love.

1. If you're a team doctor and one of the football players (that would be me) tells you that the 300 pound center sat on his foot and then felt and heard a bone in his foot go pop, spend 20 minutes convincing said player that its just a strained ligament, "we have spare crutches, but you won't need them, we'll just tape it up a bit." Clearly this 17 year old that spends hours a day slamming into other people and is currently riding so much adrenaline he's cracking jokes about his busted foot, would be wimpering if it was actually broken. After the player tells you that "it's not a ligament, its effing broke" concede that if it still hurts in a couple days maybe he should get it xrayed. The next day act baffled that the player is pissed off at you when he comes to get a cast on it, after he woke up that morning, tried to get out of bed and collapsed on the floor screaming.

2. If someone (teammate) dislocates a shoulder wait until you get to a hospital 45 minutes away to pop it back in. Refuse all attempts to knock it back in place. Clearly all the coaches and players that have gone through it before know less than a parttime LPN. And besides the 45 minutes of gruesome agony will do the tightend some good.


3. If you're a trainer and a player comes to you at halftime complaining about a hurt forearm ask him to squeeze your finger (is this some kind of physical therapy joke I'm not in on?) and then tape his arm. When the player explains that it happened when he made a tackle with his arm between the legs of the running back, "like a twig in the spokes of a bicycle", counter with "probably just a bruise from a helmet... or something." Before next weeks game be sure to tape up that arm real good, after all its 10 times the size as the other one and beet red.

2 months later the swelling goes down and the forearm has a noticeable bulge in it. Now is the time for a physician to tell the patient to get it xrayed even though its still probably just a bone bruise.

When the patient comes in to pick up his xrays laugh hysterically at him and hold them up to the light so everyone in reception can see the triangle his radius and ulna make. Be sure to point out the centimeter gap in the ulna that has partially healed.

Now armed with xrays, it is time for the physician to refer the patient to a $1000/hr specialist 90 minutes away now that the injury doesn't hurt at all.
If you're that specialist take a look at the xray then chuckle softly. Crack a joke about rebreaking it again if the patient wants it fixed so you get to chuckle loudly. Then procede to tell the patient what they've already figured out: it would have been nice if it had been diagnosed 2 months earlier but since its mostly in one (bent) piece it'll have to do.

If your the team doctor or trainer that has effed up the diagnosis of either the foot or the arm, scold said injured player at the last game of the season and his career about taking 3 aspirin instead of 2. Chock it up to roid rage when the player tells you to go **** yourself.


4.
When you go in to see a patient with a gash in the knee look it over a bit and then say, "a bandage should do it .... hmm ...the nurse already got out the sutures? Well I guess we're going to give you some stitches then." This builds the patient's confidence in your medical judgment and abilities.


5. A lesson learned on the subway: If someone has just electrocuted himself at his job at the airport, pack him full of meds and release him. There's plenty of good samaritans on the subway that will help the delirious man back to the airport where he can get his car. The smell of his burnt hair will mask the odor of the homeless guy at the other end of the subway car.

Nothing personal, but I hate doctors.
 
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