Things I Learn From My Patients

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http://www.nbcnews.com/health/budwe...ng-injured-er-patients-pilot-study-6C10925507
Many people who end their Friday or Saturday nights in a hospital emergency room have been drinking alcohol. In fact, public health experts estimate that about one-third of all injury-related ER visits involved alcohol consumption.

But what, exactly, are people drinking? What types of alcohol and even what brands? Is there a direct link between advertising and marketing and later injury?

Until now, those questions have been unanswerable, frustrating alcohol epidemiology researchers. But if results of a pilot study conducted by researchers from Johns Hopkins Bloomberg School of Public Health hold up, there may soon be a way to connect the dots.

When the Hopkins researchers surveyed ER patients who'd been drinking, they found that Budweiser was the number one brand consumed, followed Steel Reserve Malt Liquor, Colt 45 malt liquor, Bud Ice (another malt liquor), Bud Light, and a discount-priced vodka called Barton's.

Though Budweiser has 9.1 percent of the national beer market, it represented 15 percent of the of the E.R. "market." The disparity was even more pronounced for Steel Reserve. It has only .8 percent of the market nationally, but accounted for 14.7 percent of the E.R. market. In all, Steel Reserve, Colt 45, Bud Ice, and another malt liquor, King Cobra, account for only 2.4 percent of the U.S. beer market, but accounted for 46 percent of the beer consumed by E.R. patients.

"What a shocking coincidence," said none of you, ever.

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http://www.nbcnews.com/health/budwe...ng-injured-er-patients-pilot-study-6C10925507

Though Budweiser has 9.1 percent of the national beer market, it represented 15 percent of the of the E.R. “market.” The disparity was even more pronounced for Steel Reserve. It has only .8 percent of the market nationally, but accounted for 14.7 percent of the E.R. market. In all, Steel Reserve, Colt 45, Bud Ice, and another malt liquor, King Cobra, account for only 2.4 percent of the U.S. beer market, but accounted for 46 percent of the beer consumed by E.R. patients.

"What a shocking coincidence," said none of you, ever.

Further quote from the article: "Though Jernigan was quick to point out that no conclusions could be made about beer or malt liquor advertising, pricing, or even consumption based on the study since it was too small – 105 patient interviews -- and took place in only one hospital in Baltimore in mostly black neighborhood, he proved such research was possible."

Why would the comparison be to National sales figures when the study area is quite small? The comparison should be to the sales of alcohol in that area of Baltimore.
 
A 2-week-old baby's umbilical cord stump is SUPPOSED to fall off. It doesn't shrivel up like a scab.
 
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I learned that it's definitely not a good idea to wash your floor with gasoline and then decide to light up some cigarettes. But really, who could have known that?
 
I learned that it's definitely not a good idea to wash your floor with gasoline and then decide to light up some cigarettes. But really, who could have known that?

Sounds like a horrible way to commit suicide. :scared:
 
Today I learned that if you are really disappointed with your job, the best cure is to go drinking at a seedy bar. To make things more interesting, greatly exceed your ethanol tolerance and pick a fight with a 280-pound biker whose biceps are bigger than your neck.

Then, convince him that what you really want is a steel-toed boot to the calvarium. Heck, three or four would be great.

You will be rushed to the hospital as the police arrest said biker for "murder" .... But boy are they about to be surprised!

See, a really great neurosurgeon is on call at the time you're doing all this. When the ER determines that you still have a pulse, he says he will meet you in the OR for emergency surgery.

You will spend practically forever in the hospital. For fun, you have gained a tube in your throat and a significant lack of anything resembling a skull cap.

When you are finally released, remarkably free of permanent damage (only a slight tremor), you will be accepted back to the job you tried your hardest to quit in a rather permanent fashion.

Because you lived, the biker will get probation.

Your wife will divorce you. Or, at least, you will learn as soon as you wake up that she divorced you during your extended coma. (Maybe she would have stayed by your side if your life insurance hadn't lapsed!)

Just for fun, the neurosurgeon will add a good dozen slides to his powerpoint presentation on severe skull injuries (which he presents to the MS-2s every year).



(Not one I saw, but one I heard about second-hand from a nurse who worked in the ICU long ago...)
 
"I gots tha high blood; tha low sugga'; and I'mma mutha-f*ckin' mazz-MATT-ick"

....is actually a very succinct and efficient self-report HPI. I always appreciate it when patients get straight to the point.
 
A few days ago at the end of a shift, I perused the triage tracking board. EMS was en route with a guy with cc: Alien Encounter. I kinda wanted to stick around to see that one.
 
A few days ago at the end of a shift, I perused the triage tracking board. EMS was en route with a guy with cc: Alien Encounter. I kinda wanted to stick around to see that one.
Plan:

1) Page psych immediately.
2) While waiting, conduct a brief PE to certify medical clearance.
3) Most importantly, under no circumstance should you perform any type of invasive procedure(s) upon this patient. Recognize that the patient's body has already suffered from enough senseless poking and probing for one day.
 
Hallo! First of all, greetings -- I just registered; I am JoseB, Spaniard currently living and working in the Netherlands. Come from a medical family -- My father was a doctor, my mother was a nurse.

From them I got many, many stories which I think might not be out of place in this thread... I will share them with you. I don't know if similar stories have already been presented, but well... Here they go anyway :)

=================================

Busy night at the Emergency Room. Suddenly, huge commotion at the entrance! A bunch of vans arrive, chaos, shouting, and the whole ER is treated to the surreal scene of an enormous mob of really excited black-clad people half-carrying/half-pushing an open casket into the ER and demanding a doctor ipso facto.

After some minutes of utter confusion, the admissions nurse gets to talk to one of the newcomers who appeared to have been chosen as speaker for the rest (who were still wailing and crying very loudly, with huge demonstrations of hysteria). The story that was finally put together (amidst increasing demands for a doctor that were growing in volume and aggressivity) was...

(Obviously, I am rewriting it -- in actuality it was quite more disjointed and less "literary")

...The patriarch of a very important gypsy clan had died, and the whole family (plus dozens of visitors from other clans who had gone there to pay their respects) were holding the wake at his home (open casket, staying with the corpse for the whole night, the works).

Suddenly, in the middle of the night, one of the women sitting next to the casket screamed and almost fainted: The dead man had moved! In his casket! HE WAS ALIVE! DO SOMETHING!

After frantic efforts on the part of the family members (slapping the man, shaking him, spashing him with water...) had failed, they finally decided to load the casket in a van and carry it to the nearest ER. Of course, EVERYBODY who was at the wake came along.

In the end there was no option but to get a doctor to "examine" the corpse, take him for a while inside, and later announce that, unfortunately, in spite of all efforts, their beloved patriarch was finally dead. Better that than trying to explain that the guy had been dead all along and risking a full riot right in the ER!

=================================

My mother worked as a nurse at the dialysis department in the Central Hospital of my city of birth. One of her patients was a very charming gypsy woman, let's call her Maria; a really funny and witty person who loved to chat with the nurses while she was undergoing dialysis.

Well, one day, while she is there, the hospital got word that the Central Transplant Organization (in Spain transplants are coordinated country-wide) had found a compatible kidney for her. So, my mother went to talk to her and give her the good news:

"Doña Maria! Guess what! Wonderful news!"

"What is it?"

"They have found a kidney for you! Get ready, you're going to be taken to Madrid soon for the operation!"

And then Maria lets out a scream, crosses herself, and shouts: "NO WAY!"

"But why, Maria? This is your chance of having a normal life again!"

"NOBODY puts ANYTHING from a DEAD MAN inside me! Never, never, never!"

It was impossible to convince her to accept the operation, so in the end they called the transplant center and told them that the patient had declined (I am sure they found another receptor very quickly, though. Unfortunately, organs for transplant are in high demand).

The best thing was that, afterwards, when Maria was getting ready to go home after that particular dialysis session, she went to my mother and said:

"Besides -- Now I can come here every two days and spend some hours with you, my friends, talking and having a good time. I am not going to throw that away, either!"

(Now, that is somewhat charming, don't you think?) :)

=================================

This one is from my father. In the early 1940s he had the "pleasure" of being in jail for political reasons. At that time, Francoist prisons were NOT a fun place to be, especially if you were a "red" (like most of those in that particular prison were). The authorities didn't give a fig for the well-being of the prisoners; medical care was absent, and because my father was a doctor, he ended up ministering to the health of his fellow prisoners.

One day, he hears people shouting: "Call Don Jose! Call Don Jose! Quick!". My father went there, and saw three guys holding another who was shaking and convulsing and everything.

"What has happened?"

"We don't know! He just fell to the ground and began shaking like this! Looks like an epileptic fit!"

My father looked at the guy for a few moments, and told the other three who were restraining him:

"Release him"

"But Don Jose, he is having a fit! He will hurt himself!" (the place was narrow and there were some benches by the walls)

"Release him I say!"

So, the other guys, deciding that my father, as a doctor, possibly knew what he was doing, let the guy go.

After something like 20 or 30 seconds pass, my father says:

"See? Look at him. He is shaking and flipping like crazy... But, in this really narrow place, he is not hitting anything. This is no epileptic fit at all!

"Oh... So, what do we do?"

"No worries, I know what to do!"

With these words my father knelt by the thrashing guy, pulled down his pants, grabbed his balls and squeezed...

...It was a truly miraculous cure, indeed. The patient never had fits again.
 
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"No worries, I know what to do!"

With these words my father knelt by the thrashing guy, pulled down his pants, grabbed his balls and squeezed...

...It was a truly miraculous cure, indeed. The patient never had fits again.

A little clarification on the balls-squeezing part please :) was he simulating, or is it some miraculous spanish cure for a different type of seizure :laugh:
 
When you, as a reasonably intelligent adult male, slip and roll your foot, applying all of your 270+ pounds on your ankle with a nasty crunching pop - the correct answer is not to stand back up and say the sound effects were just from your boot.

The correct answer is also not work for another three hours, including such tasks as climbing ladders.

Nor is the correct answer claiming that your foot, now swollen to about the size of a watermelon after taking your boots off, will be fine in the morning and that there's no need to go to ER. While your wife may agree that broken bones that occur at 4 pm might be best treated at your doctor, when it's ignored until 9 pm, the answer is ER.

While at ER, do not sulk about every doctor wanting to look at your "minor sprain" which is actually a rather nasty ankle and foot fracture that requires surgery the next day.

I had pizza, pasta salad and cookies delivered as DH was being a rather whiny crabby pants. Sorry for making you deal with him!

It's still the orthopedic doctor's office gossip about how he was walking around on his ankle and foot.
 
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This thread is epic. While I'm sure I'll share plenty of my own stories in years to come, allow me to start with one from one of our professors:

First of all, the only real way to go hunting is if you're hammered first.

If hunting the usual deer and whatnot gets a little boring, hunting snakes is an enticing alternative. Snakes are best hunted using firearms, particularly if they are traversing rocky terrain. Your bullet will certainly not miss the snake (again, you're drunk), and would of course never ricochet off of a rock and strike you in the knee.

Should the unthinkable happen, however, it's best to blame the snake. You should make the snake pay for it by picking it up and attempting to kill it with your bare hands. The fact that it may bite you twice during this process is of no consequence.

Now you find yourself drunk, snakebitten twice, and with a bullet in your knee. While you may consider going to the ER at this point, keep in mind that your GSW would result in automatic notification of the police, which is an encounter you'd like to avoid given the outstanding warrant for your arrest. No, no, your best course of action is to consult your hunting buddies.

Fortunately for you, one of said buddies saw a couple episodes of ER, and recalled that electricity would neutralize the venom. Please let them hook you up to their car battery and repeatedly shock you for the next couple hours.

Should this innovative technique fail, don't worry, because another one of your buddies thinks he read something about snakebites in Reader's Digest or something like that, and suggests that maybe an ice bath would be helpful. Just go along with it.

Now an aside for this man's highly competent caretakers. Should you, upon noticing that your friend is now turning blue, decide that this man's condition is outside your "scope of practice" and call for an ambulance, when they ask you, "What is your address?", provide them with your home address instead of that of your friend. Then, remembering that others among you may also have warrants out for their arrest, immediately leave and let EMS figure the rest out themselves. EMS will definitely know where to find your friend, and this course of action will in now way result in them showing up at the address you gave to them, find nobody there, wait around for a couple minutes, and then leave.

Now, back to you, our victim. Despite expert medical care, your condition continues to inexplicably deteriorate. Thankfully, your girlfriend arrives at the home a couple hours after your buddies leave, and finds you in the tub, hauls you out and takes you directly to the emergency room, now drunk, shot, poisoned, electrocuted and hypothermic for several hours. The ED staff will be able to maintain perfectly straight faces as they investigate the details of your story, and will in no way discuss this with their colleagues.

...

Pretty impressive string of stupidity. Amazingly, the attending saved the guy, even if it took a crapload of antivenom. Would be curious to know his tattoo:teeth ratio... :laugh:
 
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I learned that there is no point in having your own syringe (for coke) if you let anyone use it too.
 
Sometimes we're just slapping Darwin

We passed that point long ago.

He's already laying on the floor in a pool of blood. Now we're repeatedly kicking him in the balls just for the entertainment.
 
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I learned last week that Hb A1c can drop from 10.7 to 4.9 mainly by stopping drinking soda pop. THREE two-liters a DAY!!!

How much did this guy go pee after drinking six liters of soda? I really don't want to know.

dsoz
 
Sometimes we're just slapping Darwin

No, my DH is kicking him with his cast.

Maybe it's my reading, so correct me accordingly, but - men are involved in a high majority of blatantly stupid trauma and women are involved in a majority of blatantly clueless statements. And we're breeding.

Darwin's leaping off the nearest cliff into an acid pit filled with starving sharks.
 
I learned last week that Hb A1c can drop from 10.7 to 4.9 mainly by stopping drinking soda pop. THREE two-liters a DAY!!!

How much did this guy go pee after drinking six liters of soda? I really don't want to know.

dsoz

Funny you should ask that.

1996, I was at Annual Training for the Air National Guard at a busy field site used for air to air combat simulations and various ground roles, including airbase engineering (us). Most of us have at least some first aid training, and many of us are either combat lifesavers or Red Cross certified or both.

We had a bunch of Civil Air Patrol teens doing their summer camp, learning about the USAF, search and rescue, etc, in several of the barracks.

Round about 8 Saturday night, the phone in our open barracks rings (one way--they can call in, you can't call out except to site operator). I was the only one there, quietly reading a book. Most were at the Enlisted Club for the one evening we had free.

"Engineer barracks, Sergeant Williamson."

"Hey, Williamson, it's Smith at the Fire Station. Any firefighters there?" (All the firefighters are well trained and many are EMTs).

"No, just me."

"Are you first aid qualified?"

"Yes, what's up?"

"A bunch of the CAP cadets are sick. Has anyone over there been sick?"

"What symptoms?"

"Nausea, chills, fever, vomiting."

"No, but probably once they get back from the club they will."

"Well, can you grab a rescue truck and head over to building XX? The site nurse is there."

"Suuuure." (I'm qualified on 30 or so military vehicles, including APCs, cranes, hummer gun trucks, tank haulers, backhoes and dump trucks. How hard can it be to drive a pickup with rescue gear? Not hard, really.)

I walk to the fire station, keys are in the truck, map is on the wall. I get to building XX, and the Security Police have a cordon and don't want to let me in, but the fire truck helps.

Inside, I see dozens of teens huddling under blankets (this is July) looking miserable, thermometers, puke pans, surrounded by reassuring adults.

So the nurse and I drive to the operations building, where someone may have picked the lock on the records cabinet so we could get to the kids' medical profiles without waiting for someone to drive in from Ft McCoy.

Remember: None of our people were sick. So it wasn't food related--we all used the same chow hall when not eating MREs or T-packs. There weren't supposed to be any contaminants in use. Being in Mechanical Section, I was wondering about something akin to Legionnaire's Disease, with possible bird crap or mold in the ventilation system.

So we go through the (100 some) kids' records. Ritalin. Other ADHD treatment. Some for blood sugar issues. BC pills. "WTF is a 14 year old taking Prozac for?" (several of them)

Nurse says, "Sometimes they feel unloved and if the world is against them."

"So, they feel like teenagers?"

"Yeah, I don't approve, but some doctors and parents do it anyway."

No common factors in medication.

About 15 of them were sick, with another every hour or so.

CDC out of Milwaukee was calling about vectors.

Eight or so got transported to the local clinic's ED.

I heard nothing else, went to sleep.

Sunday in the breakfast line, the nurse comes through. "You'll never guess what it was."

"Probably not."

"Caffeine withdrawal."

"..."

"They were apparently under the impression they weren't allowed to have soda on site [even though there are soda machines in the chow hall for that reason-Mike]. They got here Friday night, and some of them drink TWO TO THREE 2-LITERS OF MOUNTAIN DEW A DAY [caps mine]. They gave them some at the clinic and they were all fine."

They ran 48 hours on adrenaline then collapsed.

And that's why my kids drink milk, water or juice most of the time.
 
Ritalin, estrogens, prozac, and mountain dew.

I should try that diet sometime.
 
This thread has kept me entertained for several weeks now. Keep up the good work!

I’ve never had to cure chest pain in a human with a turkey sandwich, but I did learn something very interesting from a client:

The stomach is an ideal habitat for mice. If you think your dog ate one, proceed to freak out because you “saw the outline of the mouse running around in the dog’s chest,” and now fear he is in danger of being eaten from the inside out. Rush him to your vet. We will be happy to take x-rays if that is the only way to prove to you the mouse is dead. :rolleyes:
 
:rolleyes: No. She didn't think she was Jesus. She was just arguing with Him about what He had done with her purse. I still think stealing a purse is a very unJesuslike thing to do. You'll never see scripture that goes "And He appeared before His congregation and bestowed unto them His divine love. He then grabbed a purse and ranneth off down the block."

Old post, but I got questions -

Is the purse stealing Jesus the same on who tells some dude to go after the entirely sober person SOCMOB at 2am?

Or is he the one who tells that b**** to steal the Percocet you need for the 10/10 pain from a boo boo on your leg?
 
It is completely normal to have an ant colony living in your fat rolls. No, it doesn't tickle (I thought it would...).

:uhno:
:wtf:

._.

surely you jest, good sir?

:scared::eek::wow::barf:

Edit:
I learned last week that Hb A1c can drop from 10.7 to 4.9 mainly by stopping drinking soda pop. THREE two-liters a DAY!!!

I hadn't twigged until now what HbA1c was...
been researching glycation past couple of days
caramelizering your own proteins to death like that...
maybe it's my biochemical bent, but it seems somehow even grosser than the ant nest O.O
 
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I learned from a patient that if you violate your parole and you get word that the cops are headed to your front door, just OD on whatever's in the medicine cabinet. You'll get put on a psych hold for a day or two, and then released at a time that we can't legally inform the police about. Just lather, rinse, repeat as necessary...

Actually really irritated by this one. If you're brought in by police, we should be allowed to discharge you to them as well.
 
:uhno:
:wtf:

._.

surely you jest, good sir?

:scared::eek::wow::barf:

Regrettably, no, I do not jest. I wish. The ant colony in her fat rolls, the lice in her hair, and the roach colony living in her purse were the stuff nightmares are made of. The floor nurses were mad for days after we admitted her.
 
Regrettably, no, I do not jest. I wish. The ant colony in her fat rolls, the lice in her hair, and the roach colony living in her purse were the stuff nightmares are made of. The floor nurses were mad for days after we admitted her.

Hmm... I wonder if one of those nurses shared that story here.

You're welcome! :p
 
In the last several places I've worked the police would stay with the patient and then take him to jail upon discharge.

Yeah, our county is too damn broke to hang around for the mandatory 24-hour psych hold. They'll stick around for the run-of-the mill incarceritis stuff, but that's just too long for them.
 
Hmm... I wonder if one of those nurses shared that story here.

You're welcome! :p

She was definitely unforgettable. And I was the lucky CNA who got to clean out the roach-infested cabinet that her purse had been placed on. It was...memorable.
 
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Recently took care of a hobo who had a stroke. When we were cleaning him up, I took off his shoes and he had so much dead skin come out the floor needed to be swept. His shoes had been on for so long, his toe nails were growing transversely around his feet.
 
Okay, I had to register even though I'm not in the medical field at all. You all have been making me laugh so much since I found this forum from Customerssuck. I'm only in the 20-30 page range, but seeing so many people rag on y'all for making jokes is really irritating me. :thumbdown: I hope they never have to see what y'all see or go through what y'all have to. Keep it up, and THANK YOU for what you do/did (if you aren't anymore) :D
 
Regrettably, no, I do not jest. I wish. The ant colony in her fat rolls, the lice in her hair, and the roach colony living in her purse were the stuff nightmares are made of. The floor nurses were mad for days after we admitted her.
a one-woman ecosystem!
joyful.png

dem purse roaches
dance.gif
greedy.png
dance.gif

you mean mad as in 'angry' mad :sendoff: or mad as in 'eating the wallpaper' mad?
eek.png
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confused.png
:whoa:
Hmm... I wonder if one of those nurses shared that story here.

You're welcome! :p

the smilies from that forum are awesome (I've used some above)!
reckon this forum should have some of them?
 
Today I learned that if you're the only car in the left turn lane of a busy intersection, and a fire truck comes up behind you, full alarm, honking furiously, you should look around and shrug. To their repeated honks and waves to move, you should point at the "TURN ON GREEN ARROW ONLY" sign.

Eventually, four cars in the left traffic lane will ease forward through the intersection to let the truck through, and you should keep furiously pointing at the lights while mouthing profanities at them.
 
eek.png
chair.gif
confused.png
:whoa:
hiding inside yourself
getting out of your head
seeing the outside world
running back inside
 
the smilies they use are thus (the animated ones underneath)
VOPesb5.png

sarcastic.gif
blink.gif
wave.gif
noway.gif
yes.gif
cheeky.gif
roflmao.gif


edit: even though they do have a barf one,... they use
greedy.png
for sick things lol
 
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I had another good one at work (kids)

1. when i'm trying to get a history of your injury that's a great time to storm off because i didn't give you 1 gram paracetomal:smuggrin:

2. your arm is in a sling due to a suspected shoulder injury, it is to stay there, not to be taken out when you feel like it otherwise i wouldn't with the ling in the first place

3. do not think wearing latex gloves while treating an infected open wound is over reacting, i'll be happy for you to clean the wound without gloves

4. before the adrenaline wears off, please take the effect to clean the mud from your injury, yes it will hurt, but not as much as when i begin to scrub it out of the infected wound. :barf:

5. (for other staff) please if you give a kid medication, write the time and quantity down, it makes my life easier
 
If you are driving around with a wal-mart bag of meth looking for a customer, make sure your tail lights work.

If they don't work, and the police try pulling you over, then at least try to make it another mile down that country road before you finally get cornered and stopped (that way you are in the next hospital's area, not mine!).

If you are stopped with said wal-mart bag of meth, and you decide to eat it all, you are in for a rough couple of days (and you might run my little tiny hospital out of lorazepam) AND you will still get arrested when you are discharged.
 
Tonight I learned that it is unwise to step from a moving car so you can go back to the bar and finish the argument. It might result in being flown to the neurosurgical referral centre with subdural hemorhages and diffuse brain swelling.
As a side note,if you are going to do this people will see your embarrassing suprapubic tattoo. Just saying,
M
FYI, it read "Slippery When Wet"
 
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Literally replying just so I can find this easier in my "particpated" threads page....i think this thread means I will ditch family med and go em
 
Regrettably, no, I do not jest. I wish. The ant colony in her fat rolls, the lice in her hair, and the roach colony living in her purse were the stuff nightmares are made of. The floor nurses were mad for days after we admitted her.

Holy moly... :confused:
 
If you are sufficiently obese, then your "little buddy" may disappear. One ED tech, five experienced ED nurses, and two ED attendings will not be able to locate it for the foley. An initially-sarcastic urologist will consult in the ICU, also will be unable to locate it, and will opt for a suprapubic cath.
 
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If you are sufficiently obese, then your "little buddy" may disappear. One ED tech, five experienced ED nurses, and two ED attendings will not be able to locate it for the foley. An initially-sarcastic urologist will consult in the ICU, also will be unable to locate it, and will opt for a suprapubic cath.

Once had a mother bring her 2 year-old into the ER because she was worried about his penis being too small... He weighed 89 pounds. She didn't understand that his penis was the right size, but everything else wasn't.
 
If you are sufficiently obese, then your "little buddy" may disappear. One ED tech, five experienced ED nurses, and two ED attendings will not be able to locate it for the foley. An initially-sarcastic urologist will consult in the ICU, also will be unable to locate it, and will opt for a suprapubic cath.

I'd imagine that the SP cath would still be a pain to set up if the patient was that obese. How did he urinate before the cath was put in?
 
If you are sufficiently obese, then your "little buddy" may disappear. One ED tech, five experienced ED nurses, and two ED attendings will not be able to locate it for the foley. An initially-sarcastic urologist will consult in the ICU, also will be unable to locate it, and will opt for a suprapubic cath.

WTF?

I'd imagine that the SP cath would still be a pain to set up if the patient was that obese. How did he urinate before the cath was put in?

Messily.
 
If you are incarcerated and suicidal there are probably more efficient ways to kill your itself than consuming your spectacles. This will just buy you a colostomy when the pieces perforate the bowel.
Also always remember where you stashed your car keys. Otherwise they will be an unpleasant surprise for the doctor performing your pelvic exam. However,their discovery( with automatic car starter attached) will nicely clear up the mystery of what is causing your lower abdo pain.
 
22 yo kid is brought into ED, concussion, lots of lacerations with gravel and road debris embedded in the wounds. Overheard while he was being sutured:

Doc: "So how exactly did you do this?"
Pt: "I was longboarding down the canyon, and I ran into the back of a Sheriff's truck parked on the shoulder that I didn't see. It was a pretty sick wipeout."
Doc: "At 0100?"
Pt: "Yup"
Doc: "So why were you skateboarding down the canyon at 0100?"
Pt: "This really hot chick dared me to. She said she'd sleep with me if I did it."
Doc: "Let me give you some free advice kid. If the foreplay involves a concussion, an hour of debris removal from your wounds and the seventy odd stitches that I'm doing; you'll definitely be back when you seal the deal with this chick."

After reading this thread, the Dr's statements make a lot more sense now.
 
If you are sufficiently obese, then your "little buddy" may disappear. One ED tech, five experienced ED nurses, and two ED attendings will not be able to locate it for the foley. An initially-sarcastic urologist will consult in the ICU, also will be unable to locate it, and will opt for a suprapubic cath.

Jesus! I'm 420 pounds and its nowhere near that bad. How fat was this guy? Was he brought in by a team of Oompa Lumbas?
 
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