The secondary cellulitis? Yeah. The primary lesion, without seeing it, I would venture a maybe. Usually I&D works better though (even without ABx). I can't diagnose a man I've only seen in a mirror on camera through the internet though. It would render a hole in the fabric of space.Best part of the video is the picture of the staph infection (including a good bit of swelling around his eye) at the very end. I'm no doctor, but do ya think that could of been cleared up with only antibiotics?
OwEven better, do it while several people are taking a shower and in their frantic attempts to run out, one guy slips and rips his scrotum open on the shower drain.
Do this just as I walk in to pull your dumb ass out of there so I get to see the most horrifying and emotionally scarring thing that I've ever seen at that point in my life.
We had a guy come into the ER after crashing his bike into a chain link fence, his only injury was an ?avulsed? scrotum. Either way it was ripped open and his "little guy" was hanging out. The docs were verrrrrry generous with the pain meds, lol.Even better, do it while several people are taking a shower and in their frantic attempts to run out, one guy slips and rips his scrotum open on the shower drain.
Owwwwwww......pardon me but DAMN. OWWWW!We had a guy come into the ER after crashing his bike into a chain link fence, his only injury was an ?avulsed? scrotum. Either way it was ripped open and his "little guy" was hanging out. The docs were verrrrrry generous with the pain meds, lol.
Hahah!!! Love it! And I definately did see it on my EM elective in Philly!
Just so ya know, the Gulf Coast is just as similar, except its usually the grandmother bringining in all the grandkids.
I once read a book written by an ER doc in which he told the following story (in my words):
Woman comes into the ER. States that she has a sore belly/abdomen. A pelvic exam reveals some interesting findings. First, her vaginal vestibule is being held closed with a number of safety pins that are beginning to rust (if I remember correctly). When these are removed, several pieces of chicken- presumably making up a whole bird, were subsequently removed from her vagina. She then revealed that she was desperate to get pregnant, and thought that shoving a chicken "up there" and fastening it closed woud do the trick.
I'm not kidding- I read this book many years ago, and this story has stuck with me since. Anyone else read this anecdote? I think the doctor's name was Brown- maybe not?????
Dont think for a minute this hasn't been considered. We in Texas believe every patient has the right to a REAL reason to visit the ER and some nights wouldn't mind giving them one.
Kinda like when dad used to say "stop whining before i give you something to cry about" i reckon
If you're a crotchety old lady and you called 911 to have the ambulance bring you to the ER you probably shouldn't take the attitude "I don't know nuthin' 'bout 'nuthin and I ain't answering no questions no how." It really makes it tough to figure out what to do with you.
My attending enlightened me today to an almost house-universal dx: resistant to common sense.
I know what you mean with that. It drives me crazy when I am on a squad call and ask a pt what medications they take and they respond with "some heart pills" or "blood pressure medication" or some completely non-helpful answer like that.
this one takes some sort of cake guys. i don't know what i learned from her, other than some people are just unbelievablely stupid.
44 y/o frequent flier. previously diagnosised CAD... BUT has refused to get cathed (i don't know why they didn't do it at the same time as the angiogram either). lives on a diet of fast food and cigarettes and comes to the ED several times a month complaining of severe chest pain. obviously this isn't someone you can just let walk out the door, seeing as how she could have an AMI at any time. she's openly non-compliant with her meds (she can't afford them... wouldn't want to take away from her big mac's and cigarettes), and says if you try to admit her she'll sign out AMA (she's done so many times before... as soon as she gets moved onto the floor she bolts). however, she demands that you treat her chest pain. 20mg's of MS (that's right, 20... it takes a lot when you weight 350lbs) she's getting "some" relief but still having chest pain. the best we've ever been able to do is get the pharmacy to fill some of her meds for free and have her sign out ama from the ED. I haven't seen heard anything about her in awhile and honestly i don't know if that's because she got tired of us being rude to her or if she finally died.
this patient =
And then there was the ER doc who asked me if I was "allergic to any antibiotics" -- just like that, and didn't listen to anything I said after "yes"This totally does not give adequate credit to the pt with multiple abcesses who is allergic to "some kind of antibiotic"
After your cardiac arrhythmia is corrected using an electric shock we will draw blood that shows elevated cardiac enzymes, thus proving myocardial infarction.Anyone want to translate this part for those (like me) who have no idea what it means? Thanks!
SVT = Superventricular tachycardia (fast heart rate)Anyone want to translate this part for those (like me) who have no idea what it means? Thanks!
I actually in a (and only once) replied to a pt asking ME to tell HER why she came to the hospital sweetly replied "Hun, this is the ER, not psychic friends network"
Imagine my surprise at earning a 3 day vacation for that.......
After your cardiac arrhythmia is corrected using an electric shock we will draw blood that shows elevated cardiac enzymes, thus proving myocardial infarction.
Thanks! I was lost after svt.SVT = Superventricular tachycardia (fast heart rate)
converted = heart rate slowed by treatment with return of "normal" heart rate
ruled in by enzymes = evidence of a heart attack by presense of specific enzymes in the blood.
The patient in question damaged his heart by taking drugs.
Maybe this was a therapeutic intervention! Weren't maggots FDA approved to eat away the dead flesh because they don't eat the fresh? Cleans it out for you!When you are a parapalegic with a severe necrotic ulcer, flys may lay eggs in your wounds, leaving you with a maggot infestation and a free trip to the ED.