-
CycleTrack and SDN are teaming up to make medical school admissions more transparent and accessible! Read the announcement to learn how we’re supporting the future of CycleTrack’s free application-tracking tools .
Things I Learn From My Patients
Started by docB
Get help with your application
Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.
I'll bet you do real well with the ladies 🙄
-Mike
-Mike
JaySin said:
In one of the REALLY old St. John Ambulance first aid training books (from the early 1900's) it talks about Hysteria. It says something about it usually being noted in young females. One of the treatments is to slap her across the face!
Advertisement - Members don't see this ad
That's nearly as offensive as "status hispanicus"tiger_lily said:In one of the REALLY old St. John Ambulance first aid training books (from the early 1900's) it talks about Hysteria. It says something about it usually being noted in young females. One of the treatments is to slap her across the face!
In regards to the above, as one of the pulmonologists I used to work with (he's Cuban and the one who introduced me to the above name for this "condition") was fond of saying: "Never forget you can't spell 'Hispanic' without panic". 
tiger_lily said:In one of the REALLY old St. John Ambulance first aid training books (from the early 1900's) it talks about Hysteria. It says something about it usually being noted in young females. One of the treatments is to slap her across the face!
We stopped doing it because we can't bill for it anymore.
But every doc has stories about it working, like a precordial thump . . .
mike
I find the a punch to the solar plexus works equally well in either condition, and actually has more clinical effect than a standard precordial thump. Especially if you follow through with WWE style flying elbow to the throat once they are down (in the case of hysterical pt). This step may be omitted if ROSC is obtained in the cardiac arrest patient.mikecwru said:
Considering the origins of the hysteria diagnosis, I'm not really surprised. 🙄tiger_lily said:In one of the REALLY old St. John Ambulance first aid training books (from the early 1900's) it talks about Hysteria. It says something about it usually being noted in young females. One of the treatments is to slap her across the face!
I'll treat hysteria like that. 👍
doctawife said:
Had to laugh out loud yesterday. Out of the thousands of chief complaints I've transcribed in ER reports, I finally came across the most original: The attending dictates the patient's chief complaint was "Go to Hell".
Yes, he ended up with a free ride over to the local funny farm in 4-point restraints.
I got written up once for vulgarity in an EMS run report when I charted the patient's chief complaint as "Let me go you f--king pig! I don't know nothing about those motherf--kin' drugs!"/Cardiac arrest due to drug ingestionLevel_II_Trauma said:
PM me and we'll schedule an appointment 😉HIANMI said:
DropkickMurphy said:
I don't know about EMS run sheets (reports) but I do know if it's a direct quote from the patient, it is acceptable to repeat the exact content of what was said in your medical report. Sometimes it's the only way to get an accurate description of the patient's demeanor and abusive behavior towards the staff and can legally validate why a patient is restrained, either physically or chemically...or both!
Just gotta work around those open-door county hospitals long enough and you stop being conservative about how you document patient behavior!
Advertisement - Members don't see this ad
Chronic Student said:
Im sorry that i dont have that much sypathy for a pt. thats CC is a direct result of her crying. Maybe next time i'll have a cry with them. Or maybe i would cry after one of the following...
A. While driving 70mph in a 10,000 pound vehical thru red lights and traffic i or another driver wrecks and is hurt or even killed.
B. While im attending to little miss lonely girl someone has a real emergency and suffers because it takes to long for another unit get to them and help.
PM me then LOL.....as Hianmi said....pro bono
I'm not conservative at all about it. It was the new RN who got all uppity about how I charted. Our medical director told her to shut up.Level_II_Trauma said:I don't know about EMS run sheets (reports) but I do know if it's a direct quote from the patient, it is acceptable to repeat the exact content of what was said in your medical report. Sometimes it's the only way to get an accurate description of the patient's demeanor and abusive behavior towards the staff and can legally validate why a patient is restrained, either physically or chemically...or both!
Just gotta work around those open-door county hospitals long enough and you stop being conservative about how you document patient behavior!
DropkickMurphy said:
Didn't mean to imply you personally were being conservative, just in the general sense. Obviously, you weren't conservative at all in that you didn't hesitate not to censor your report. I can relate regarding the "new" RNs reaction, a lot of them seem to think they know all aspects of medicine, including the business/liability aspects. Some of them don't have a clue regarding the fact that, if you get your ass hauled into court over a particular case like this, you don't want to have to "ad lib" what the 5150, or meth-psychotic (or just the dingus patient), was screaming at the staff. You want to have it down on paper, in black and white, right in front of you, and the best way to do that is to document exactly what happened at the time it happened.
Right on for your medical director. He/she knows their stuff! 😉
I have learned that a 5 year old child with bilat. Femur Fx's can be loaded in the car since the cost vs. his health condition is much more important. The incident:
a few years ago while doing volunteer ski patrol we had a 5 year old kid with bilat. femur fractures and had been knocked unconscious. His parents were and insisting there was no way we were going to load him into the air ambulance because he didn't have the money for the bill. Of course parent's didn't get their wish on that one. Ironic that the child was on a state funded medical type program (not insurance), but they were at a ski resort on rental equipment which surely cost them $76+ per person, perhaps a little less for the little guy on an advanced slope beyond his abilities, and the cost of the gas to drive approx. 180 miles to the aforementioned ski resort. Parent's also were worried that the state medical wouldn't pay for the bills because they were skiing in another state.
a few years ago while doing volunteer ski patrol we had a 5 year old kid with bilat. femur fractures and had been knocked unconscious. His parents were and insisting there was no way we were going to load him into the air ambulance because he didn't have the money for the bill. Of course parent's didn't get their wish on that one. Ironic that the child was on a state funded medical type program (not insurance), but they were at a ski resort on rental equipment which surely cost them $76+ per person, perhaps a little less for the little guy on an advanced slope beyond his abilities, and the cost of the gas to drive approx. 180 miles to the aforementioned ski resort. Parent's also were worried that the state medical wouldn't pay for the bills because they were skiing in another state.
BTTiger said:
Well, the only thing that would make the story acceptable is IF the family went skiing on one of those 'buy a tank of gas and ski for free' deals that northeastern gas stations did in the mid-1990s.
I got my hubbie hooked on snowboarding courtesy of Shell 'round about 1996.
BTTiger said:
it's not an uncommon concern for parents to have. also, some medschool parents are able to get their kids on medicaid because they make under the allowable income-- so not everyone on medicaid may fit what you've seen before. either way i don't begrudge low income families a family vacation. for all you know they may have saved all year for it.
i understand your venting, but try not to be *that* jaded already, lol.
--your friendly neighborhood pediatric caveman
What? No witty signature sign-off this time, my anatomically disproportionate friend?Homunculus said:
If your female loved one is prone to grand mal seizures, do not, i repeat do not engage in oral sex
Thanks for that mental image.
Would you like mustard and sauerkraut with that ma'am? 😱
-Mike
Would you like mustard and sauerkraut with that ma'am? 😱
-Mike
I'm not a doc but I did learn something from a casual friend of mine...
When you start off your day at 6AM to travel on buses and walking outside most of the day and haven't had anything to drink on a very hot day... you're prune to suffer from severe dehydration. YOU MUST drink Lots of fluids! Take a few bottle of waters with you when traveling.
When you start off your day at 6AM to travel on buses and walking outside most of the day and haven't had anything to drink on a very hot day... you're prune to suffer from severe dehydration. YOU MUST drink Lots of fluids! Take a few bottle of waters with you when traveling.
Advertisement - Members don't see this ad
8
8744
Anuwolf said:
This thread has gone downhill. I was waiting for the punchline, something to show how idiotic the patient was but I have to confess that I, myself, have been dehydrated and even suffered heat exhaustion on more than one occasion.
"Some dude stole my water bottle while I was standing on the corner minding my own business."
I think the problem with this thread is that nobody has any good stories.
I did ask one of my patients if she had black stools to which she replied, "No, but my boyfriend has a brown couch."
don't try to get "high" off of anything containing tylenol with your 15 year old girlfriends at a sleepover. you will just end up very very sick and get to drink a lot of charcoal, leaving you looking quite hot with that charcoal mustache.
🙄 You have to love stupid teenagersjoanofarc0907 said:
That is one of the funniest typos I've seen though.Anuwolf said:
D
deleted109597
A couple...
Do not jump feet first from a second story. Bilateral calcaneal fractures, bilateral femur fractures, and a stable pelvis fracture do not make depression better.
On OB, a patient comes in with severe von Willebrand's disease. As in, <1% activity, or a better way to put it, her hematologist showed up before the MFM who was to deliver her. During a prior delivery she was bleeding out her eyeballs and almost died. So for this one, after getting recombinant factors, and sewing up an actively bleeding labial lac while the first 2 of 4 units of blood are going in, she asks, "Can I go outside and smoke a cigarette?" When told she was receiving blood products, she said, "I can take the blood outside with me, just put it on that rolling pole."
Do not jump feet first from a second story. Bilateral calcaneal fractures, bilateral femur fractures, and a stable pelvis fracture do not make depression better.
On OB, a patient comes in with severe von Willebrand's disease. As in, <1% activity, or a better way to put it, her hematologist showed up before the MFM who was to deliver her. During a prior delivery she was bleeding out her eyeballs and almost died. So for this one, after getting recombinant factors, and sewing up an actively bleeding labial lac while the first 2 of 4 units of blood are going in, she asks, "Can I go outside and smoke a cigarette?" When told she was receiving blood products, she said, "I can take the blood outside with me, just put it on that rolling pole."
Ah, the whorehouse fracture.
D
deleted109597
indo said:
I'm guessing it comes from jumping out the whorehouse window to avoid being caught.
I follows the same lines as the rule that if you have bullet holes in your butt but not in your pants don't even bother trying to make up some bogus story.IbnSina said:
Or, if you're gonna tell us that you got that tamponade from "falling on a knife," you need to think of an explanation for the second stab wound, because we MIGHT ask how it got there. Gotta love trauma surg at the county hospital 🙄
If you're going to strap on a parachute and jump out of a plane, its a good diea to aim for the landing zone. 150-foot trees are difficult to climb. Oh, and you WILL be incessantly mocked by your buddies once we get you down. Jumper was completely uninjured, by the way.
At least that's what I was told by an orthopedic surgeon once when he was showing me an x-ray of a guy with calcaneal fx.IbnSina said:
Advertisement - Members don't see this ad
DropkickMurphy said:
Whether it was made up or not. Its catchy and I understood it right off the bat.
Somebody has to make this stuff up so we can have new pimp questions!
-mike
Concur with above. It made perfect sense to me.
Just like a "Janitor's fracture" is any fracture so obvious that it can be spotted from ten feet away, by someone with no medical training whatsoever, who merely glances at the radiograph while emptying the trash bin.
Just like a "Janitor's fracture" is any fracture so obvious that it can be spotted from ten feet away, by someone with no medical training whatsoever, who merely glances at the radiograph while emptying the trash bin.
If your a 15 yo confused little Emo kid it is probably not the best idea to snort ambien right before your mom comes in to kiss you goodnight. But if you do please don't be suprised when she calls an ambulance because she found you passed out of the floor. Also don't be suprised that the medic taking you to the hospital really doesn't care that you where trying to find the proper dosage that would give you a trip much like mushrooms but not make you pass out and forget the last 12 hours. But be aware that said medic and hospital staff will be highly amused as you look under your hospital bed for the motor that is holding you up, and lastly understand that from this day forward you will be knowen as Ambien boy
medic15 said:
I'm sure the company of Ambien would love this! I bet if they're reading this right now... they'll try their best to find this kid... to put him on their next Ambien commercial. Imagine the outcome of the commercial!
this one is actually something i've learned from patients. and it's not funny. i'm quite serious about it. i'm in the midwest. the very midwest. lots of cowboys. and not the kind from brokeback mountain.
anyway. don't participate in rodeos. that's what i've learned. the most horrible and most painful things i've ever seen were both the result of rodeo injuries (one quite recently, hence the post).
most horrible thing i've seen:
guy got bucked off of a bull which was then mauling and kicking the **** out of him. the bull jumped and landed right on the guys sternum with one of it's hoofs. the hoof punched right through the the sternum and ripped the right side of the heart and mediastinum apart. there was a perfect hole punched into this guys chest through his sternum. the damage was unbelievably extensive and i don't think that even if this would have happened in an OR with two cardiothoracic attendings right there that the pt would have had a shot. as it was, it was like a 15 minute transport to the hospital and the guy was long gone by the time he got to the ED. i've never seen so much blood. we met the ambulence and the back of the truck and paramedics were completely covered. the pt had lost most of his blood volume. anyway, it really sticks out in my mind as one of the worst traumatic injuries i've ever seen.
the most painful thing:
this poor guy recently defined 10/10 pain for me. he was bucked off of a horse and landed on his sacral area (this adds up to like a 8+ foot fall). he showed up and was just completely writhing in pain. he was a bad ass looking cowboy, and his was screaming and crying in pain. not whimpy crying like some people do, this was the real thing. it's that sound that just makes the hair on your neck stand up. anyway, he couldn't bear wieght or stand b/c of the pain, couldn't sit, couldn't lie on his back. the only thing he could handle was laying on stomach and even that was excruiciating. we cut off the shirt and pants and though there was no visible deformity, you could watch the muscles in his back and right thigh going through these big spasms that looked just aweful. couldn't get him in a good position for the l-spine series on plain film even after a bunch (and i mean a bunch) of demerol and robaxin (IV, not IM). anyway, we CT'ed him and he had transverse process fractures of L2, 3, 4, 5 and he had crushed his sacral hiatus as well. i don't know exactly why this was such a painful ortho injury, i'm guessing because the paraspinal muscles were still connected to the broken transverse process's (wtf is pleural for process?) and spasming so severely. anyway we ended up getting his pain undercontrol with pca dilauded, but he was snowed for several days and still extremely uncomfortable.
so yea, i learned that everyone should stay the **** away from rodeos. seriously. bad things happen which you piss much larger mammals off.
anyway. don't participate in rodeos. that's what i've learned. the most horrible and most painful things i've ever seen were both the result of rodeo injuries (one quite recently, hence the post).
most horrible thing i've seen:
guy got bucked off of a bull which was then mauling and kicking the **** out of him. the bull jumped and landed right on the guys sternum with one of it's hoofs. the hoof punched right through the the sternum and ripped the right side of the heart and mediastinum apart. there was a perfect hole punched into this guys chest through his sternum. the damage was unbelievably extensive and i don't think that even if this would have happened in an OR with two cardiothoracic attendings right there that the pt would have had a shot. as it was, it was like a 15 minute transport to the hospital and the guy was long gone by the time he got to the ED. i've never seen so much blood. we met the ambulence and the back of the truck and paramedics were completely covered. the pt had lost most of his blood volume. anyway, it really sticks out in my mind as one of the worst traumatic injuries i've ever seen.
the most painful thing:
this poor guy recently defined 10/10 pain for me. he was bucked off of a horse and landed on his sacral area (this adds up to like a 8+ foot fall). he showed up and was just completely writhing in pain. he was a bad ass looking cowboy, and his was screaming and crying in pain. not whimpy crying like some people do, this was the real thing. it's that sound that just makes the hair on your neck stand up. anyway, he couldn't bear wieght or stand b/c of the pain, couldn't sit, couldn't lie on his back. the only thing he could handle was laying on stomach and even that was excruiciating. we cut off the shirt and pants and though there was no visible deformity, you could watch the muscles in his back and right thigh going through these big spasms that looked just aweful. couldn't get him in a good position for the l-spine series on plain film even after a bunch (and i mean a bunch) of demerol and robaxin (IV, not IM). anyway, we CT'ed him and he had transverse process fractures of L2, 3, 4, 5 and he had crushed his sacral hiatus as well. i don't know exactly why this was such a painful ortho injury, i'm guessing because the paraspinal muscles were still connected to the broken transverse process's (wtf is pleural for process?) and spasming so severely. anyway we ended up getting his pain undercontrol with pca dilauded, but he was snowed for several days and still extremely uncomfortable.
so yea, i learned that everyone should stay the **** away from rodeos. seriously. bad things happen which you piss much larger mammals off.
