Things I Learn From My Patients

Discussion in 'Emergency Medicine' started by docB, May 2, 2003.

  1. SDN is made possible through member donations, sponsorships, and our volunteers. Learn about SDN's nonprofit mission.
  1. ERMudPhud

    ERMudPhud Back for a visit 10+ Year Member

    1,086
    17
    Feb 24, 2003
    Turn of the snowblower before you try to manually disimpact it.
     
  2. SDN Members don't see this ad. About the ads.
  3. EctopicFetus

    EctopicFetus Keeping it funky enough 10+ Year Member

    10,145
    113
    May 3, 2004
    Arizona
    When crossing the US - Mexico border be cautious of the minutemen.. They (someone) fired a high powered rifle thru this guys femur!
     
  4. loraksus

    loraksus

    5
    0
    Jan 2, 2007
    If you have a cyst on your face and are scheduled for surgery to get rid of it, by all means, pop it in front of a mirror, at home, with your "friend" videotaping.

    Be sure to say "I swear to god, I'm not going to need the surgery" while your friends retch in the background.
    Then, wait a week - by which time you will have a fairly large staph infection taking up a quarter of your face (that's a bad thing, right?) - and take a picture.

    Since you're in the younger generation, by all means, post it on the Internet. http://www.liveleak.com/view?i=e240c00440

    This may be fairly disturbing, but I'm sure you folks have seen worse. The retching and flying pus might get to you though.

    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? ;)

    BTW, this thread - Awesome. Sad in some parts (the wife of the burned soldier was pretty depressing)
     
  5. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner SDN Moderator 10+ Year Member

    7,834
    2,714
    Aug 2, 2006
    Texas
    Physician
    Faculty
    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.
     
  6. loraksus

    loraksus

    5
    0
    Jan 2, 2007
    My recent story... (personal experience, yeah, I know I'm brilliant...)
    When doing electrical work while renovating a bathroom, make sure that your alcoholic dad turns the power back on.
    Then, after you come to an unknown number of minutes later, seated on the floor and not realizing what the hell has happened, don't bother to go and see a doctor until you break your hand 4 days later.
    ER doctors love that and will tell you that you made an extremely wise choice in not dropping by...


    -----------------------
    And another... from years back while in Cadets up here in Canada (or, why my experiences at summer camp strongly influenced my decision to not to go into the military)

    Not really my patient (although I did get my first aid qualification a few weeks earlier and I did tell everyone to get the hell out - having uhh, some previous experiences with chlorine gas)

    By all means, when cleaning the head, pour a bit of bleach into an ammonia bottle. If it starts to get warm and starts making gas try to "put it out" with more bleach (cause, you know, it looks sort of like water and must work the same way)

    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.
    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.


    -----------------------
    On a somewhat related topic...
    It's also really cool to run around with a broomstick in the shower and poke people in the behind. Especially if you get splinters in someone's derrière that requires a trip to the doc.

    Getting arrested at 14 by MPs, chewed out by a extremely pissed off RSM and threatened with time in a military prison is something that everyone should experience in their early teen years.
    Oh, your parents will really appreciate that the military flew you back home on a military aircraft, especially when they get the bill for the transport and for the medical treatment of the victim.
     
  7. MirrorTodd

    MirrorTodd It's a gas. 10+ Year Member

    15,010
    4,893
    Apr 22, 2006
    Nowhere
    MDApps:
    Ow
     
  8. JaySin

    JaySin Junior Member 2+ Year Member

    27
    1
    Jul 20, 2006
    I've heard that story before.
     
  9. Taaki

    Taaki Member 2+ Year Member

    41
    0
    Jun 9, 2006
    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.
     
  10. Owwwwwww......pardon me but DAMN. OWWWW!
     
  11. AngelaD

    AngelaD

    4
    0
    Jan 3, 2007
    Soooo...I've officially spent hours here that I should have spent reading my text for class next week instead. Great stuff!!! Thanks for all who have contributed to my procrastination!! :) Now that I'm finished, I think I hear Cecil's and Henry's and Mosby's calling my name!! :sleep:
     
  12. mikecwru

    mikecwru M.D. = Massive Debt 7+ Year Member

    948
    11
    Oct 21, 2002
    Ohio
    Don't jerk off with a foley in place.


    mike
     
  13. ERMudPhud

    ERMudPhud Back for a visit 10+ Year Member

    1,086
    17
    Feb 24, 2003
    I have to admit I'm curious. What happens if you do?
     
  14. MirrorTodd

    MirrorTodd It's a gas. 10+ Year Member

    15,010
    4,893
    Apr 22, 2006
    Nowhere
    MDApps:
    Is it impossible to orgasm that way? Nevermind the pain, but where would the semen go? Assuming we're talking about a guy here.
     
  15. signomi

    signomi Amongst the Gravelings 2+ Year Member

    After your suicide attempt, check into the ED with your brother's name. No one will eeeeeever pick up on that and your brother totally will not mind.

    Sticking your fingers up your butt and pulling stool out and wiping it all over your bed and everything within reach is a great new hobby. And roommates love the odor.

    If the fentanyl patch isn't working well enough, just eat it.

    A blood transfusion running into your arm vein can directly exit through your anus. Who knew?
     
  16. Thank God.....that means I'm not the only one wondering that..... :laugh:
     
  17. mikecwru

    mikecwru M.D. = Massive Debt 7+ Year Member

    948
    11
    Oct 21, 2002
    Ohio

    You'll dislocate the foley and gum up the inside of the foley so it won't drain.

    Plus, you'll provide hours of laughs for the attending ED doc on overnight.

    mike
     
  18. Laane

    Laane World viewer 2+ Year Member

    If you (41 year old female) come in with terrible stomachache and you are worried that it is some cancer and we pull out a condom.. don't accuse us of planting it there..
    It's your problem if your husband doesn't use them
     
  19. f4nt4

    f4nt4 2+ Year Member

    10
    0
    Jan 19, 2007
    Or if the police drag your overdosed father into the ER combative and in cuffs, Once we call the code and pronounce him is the perfect time for the toothache/chronic back pain/carpal tunnel kids (yes, all three of them) to check in to be treated.

    And hey, mom may as well get some ativan for the funeral while we're all here, right??????

    (
     
  20. f4nt4

    f4nt4 2+ Year Member

    10
    0
    Jan 19, 2007
    Mine was a 38 yr old female crack addict who gave discounts for the colostomy cuz she "dont have to take my pants all off"

    rural south georgia
     
  21. f4nt4

    f4nt4 2+ Year Member

    10
    0
    Jan 19, 2007
    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
     
  22. f4nt4

    f4nt4 2+ Year Member

    10
    0
    Jan 19, 2007
    How about a co-worker with a near complete BKA from a rotary mower she lay trapped under for 3 hours. Thank God she had the fortitude to use her shredded blue jeans as a tourniquet...... Her request on arrival to ER: "can you just put some lidocaine in it for me?"
     
  23. f4nt4

    f4nt4 2+ Year Member

    10
    0
    Jan 19, 2007
    The doc's name was brown, but I dont recall the name of the book. It also highlighted the story of a lady with purple vaginal discharge. Her OB/GYN had recommended using "jelly" as a lubricant and she chose grape........ go figure
     
  24. loraksus

    loraksus

    5
    0
    Jan 2, 2007

    You, uhh, may want to kind of quote the posts you're replying to, so people aren't so confused ;)
     
  25. ISR

    ISR Junior Member 2+ Year Member

    60
    1
    Aug 16, 2006
    San Antonio, Texas
    Are you sure that'll help? Aren't we all in a perpetual state of confusion?? :confused: :)
     
  26. FoughtFyr

    FoughtFyr SDN Lifetime Donor Lifetime Donor 10+ Year Member

    2,216
    25
    Mar 19, 2003
    There was an issue with the servers. He/she probably did quote the post they were referring to.

    - H
     
  27. f4nt4

    f4nt4 2+ Year Member

    10
    0
    Jan 19, 2007
    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.......;)
     
  28. f4nt4

    f4nt4 2+ Year Member

    10
    0
    Jan 19, 2007
    My new favorite is an original that just fell out of mouth one night...
    FTI (Failure to Impress)

    I have found it to be quite an effective diagnosis for a large majority of ER pts

     
  29. f4nt4

    f4nt4 2+ Year Member

    10
    0
    Jan 19, 2007
    This totally does not give adequate credit to the pt with multiple abcesses who is allergic to "some kind of antibiotic"

     
  30. f4nt4

    f4nt4 2+ Year Member

    10
    0
    Jan 19, 2007
    Your lady is alive and well in Texas, I see her about twice a month out here. ;) ;)

     
  31. ISR

    ISR Junior Member 2+ Year Member

    60
    1
    Aug 16, 2006
    San Antonio, Texas
    Oh, sure. Bring all the crazy ones to TX.
     
  32. tiggers

    tiggers

    7
    1
    Nov 16, 2006
    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"

    He stepped out of the room for a prescription pad and returned with a scrip for Erythromycin.

    My response? "Yep, that's the one I'm allergic to."

    The look on his face was priceless -- and yes, I know it's an uncommon allergy, but hey, I'm not allergic to ANY pain meds.
     
  33. emedpa

    emedpa GlobalDoc 10+ Year Member

    6,014
    283
    Aug 25, 2001
    Taking an Away team....
    I learned 3 important lessons this week:

    1. do not inject heroin mixed with meth INTO YOUR PENIS because you will develop chest pain and svt. after you are converted you will rule in by enzymes

    2. do not smoke WHILE SIPHONING GASOLINE WITH YOUR MOUTH
    (enough said...burn center...etc)
    the tech asked me how tightly to wrap the neck burns with silvadene impermeated gauze...my response, "tight enough that he can't reproduce"

    3. if you are a hardcore alcoholic with a blood alcohol 4 times the legal limit and a head injury the best way to get service is to threaten everyone in the dept while demanding a head ct from the front door. as soon as the head ct is ordered the best way to assure a timely study and appropriate intervention is to elope from the dept without notifying anyone on staff before the study is done.also give us a fake name and address so we can't find you to tell you that you are at high risk for a subdural bleed.
     
  34. Rbrav

    Rbrav Junior Member 10+ Year Member

    91
    0
    Aug 28, 2004
    By now, we've all learned that our patients are never to blame for what they do to themselves. At least they're finally admitting it straight-up: Yesterday I saw a patient whose T-shirt read, "I am not responsible for my actions."

    I wished I'd had on a T-shirt that said, "But apparently I am."
     
  35. membsr-8890

    membsr-8890 2+ Year Member

    71
    0
    Sep 18, 2006
    ...that jumping out of a moving vehicle going 60+ mph isn't nearly as dangerous as it seems.

    I've seen not one but three patients who have completed this maneauver and come out unscathed, just a few abraisions. Maybe I should give it a try...
     
  36. ForbiddenComma

    ForbiddenComma Tanned for Bowling 7+ Year Member

    929
    18
    Oct 16, 2004
    Well, if there are three things that make you happy in life, why not combine them all together? :rolleyes:
     
  37. SailCrazy

    SailCrazy I gotta have more cowbell 10+ Year Member

    1,922
    7
    Feb 26, 2004
    Procrastination Island
    Anyone want to translate this part for those (like me) who have no idea what it means? Thanks! :)
     
  38. SoCuteMD

    SoCuteMD 10+ Year Member

    8,669
    695
    Nov 28, 2005
    No more rounding!
    After your cardiac arrhythmia is corrected using an electric shock we will draw blood that shows elevated cardiac enzymes, thus proving myocardial infarction.

    How's that?
     
  39. FoughtFyr

    FoughtFyr SDN Lifetime Donor Lifetime Donor 10+ Year Member

    2,216
    25
    Mar 19, 2003
    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.

    - H
     
  40. Jeff698

    Jeff698 Chief Resident 10+ Year Member

    1,995
    9
    Aug 11, 2000
    Salado, Texas

    As a general rule, the better it felt when you said it, the more trouble it's going to get you into.

    Sometimes, though, its just worth it. I HATE it when I ask a patient how I can help them and they say "I don't know, you're the doctor".

    Psychic friends network. I like it. That may be worth a day off.

    Take care,
    Jeff
     
  41. SailCrazy

    SailCrazy I gotta have more cowbell 10+ Year Member

    1,922
    7
    Feb 26, 2004
    Procrastination Island
    Thanks!:thumbup: I was lost after svt. :oops:
     
  42. downtownit

    downtownit SDN Administrator

    3
    0
    Apr 4, 2006
  43. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner SDN Moderator 10+ Year Member

    7,834
    2,714
    Aug 2, 2006
    Texas
    Physician
    Faculty
    Wow. In after the lock.
     
  44. ERMudPhud

    ERMudPhud Back for a visit 10+ Year Member

    1,086
    17
    Feb 24, 2003
    Anybody know why the thread got split and locked? It wasn't even that long
     
  45. ForbiddenComma

    ForbiddenComma Tanned for Bowling 7+ Year Member

    929
    18
    Oct 16, 2004
  46. MirrorTodd

    MirrorTodd It's a gas. 10+ Year Member

    15,010
    4,893
    Apr 22, 2006
    Nowhere
    MDApps:
    It looks like they're enforcing the 1k rule now. Threads that exceed 1k are getting closed. It used to be 10k.
     
  47. Miami_med

    Miami_med Moving Far Away Moderator Emeritus 7+ Year Member

    Threads that are over 1k apparently have a disproportionate impact on server speed, and they are limiting threads to 1k in order to keep the server moving quickly.
     
  48. emtp6811

    emtp6811 iLurk 5+ Year Member

    124
    0
    Sep 24, 2005
    Over there
    MDApps:
    Awesome! I'm totally going to steal this and put it in my signature!
     
  49. Miami_med

    Miami_med Moving Far Away Moderator Emeritus 7+ Year Member

    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.
     
  50. emtp6811

    emtp6811 iLurk 5+ Year Member

    124
    0
    Sep 24, 2005
    Over there
    MDApps:
    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!:p
     
  51. I dunno about the FDA, but it worked for Russell Crowe in Gladiator--that's good enough for me.
     

Share This Page