Things I Learn From My Patients

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

  1. Apollyon

    Apollyon Screw the GST
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    Dude - in a word -" 'murica".

    You find singular something that is legion and quotidian he in the ol' US of A.
     
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  3. Fox800

    Fox800 That drug that starts with "d"...
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    Repeat x20 times daily during cold/flu season.

    Don't try Advil then get indignant when I send you home with Advil for pain.
     
    #3902 Fox800, Mar 4, 2017
    Last edited: Mar 5, 2017
  4. BoardingDoc

    BoardingDoc Don't worry. I've got my towel.
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    While I understand that they derive from different sources, I enjoy the use of both " 'murica" and "quotidian" in the same response.
     
  5. Birdstrike

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    Only one country on Earth where you can do both.

    Sincerely,
    Bluto


    Sent from my iPhone using SDN mobile
     
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  6. Aquar1us

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    Brutus Bluto!
     
  7. MadScience101

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    Don't attend a flat-warming party, get drunk and somehow partially sever your pinky finger while climbing like a spider on the underside of a dinner table to impress the ladies.

    When the paramedics arrive, offer them beer too, but don't accept their advice that you should go to hospital...

    Instead, down your beer, tear off your pinky (severing what little tissue was still holding it on), wipe your bloody stump-hand on your shoulder, throw what's left of the finger at them and demand more beer.

    Apologise by offering them more beer too.


    ...second-worst party ever.
     
    #3906 MadScience101, Mar 7, 2017
    Last edited: Mar 7, 2017
  8. killerleaf

    killerleaf beware, beyond there be dragons
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    wait, SECOND-Worst??????
     
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  9. MadScience101

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    Lol - definately second-worst ;) Just to clarify - I was a bystander during the whole proceedings of hte second-worst-party-ever: I was pretty drunk and offered some very minor assistance...

    ------

    But as for the worst party ever...?

    In my third-year Fresher's week (by which point I had gotten bored of the whole idea of "Fresher's Week") I decided to remain sober - and was enjoying some quiet time with a girl I'd met (no, literal quiet-time - get your mind out the gutter - we were reading papers and discussing them!) when I was rudely interrupted by a frantic knocking upon my door.

    My new flatmate, aware that I had attended a 12-hour first aid course the week prior, needed me to help - come quick - it's an emergency!!!

    Lo' and behold - there's a classic heroin-OD right there in my kitchen - needle sticking out the arm, refusing to breathe and turning a magical shade of blue... me, a freshly-trained first-aider? Match made in heaven.

    I can't actually remember if he was having a heart attack as well? I mercifully blanked most of the particulars... I do remember being peeved that I didn't have my cpr face-mask though...

    There was also chille con carne all over one of the sofas... I never did find out what was all about... and the OD-guy? Didn't even say "thank you"! The nerve!

    ...worst-party ever.
     
  10. killerleaf

    killerleaf beware, beyond there be dragons
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    ***makes note to never party with MadScience***
     
  11. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner
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    First worst
     
  12. MadScience101

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    Lol, it's alright - all my parties are fine - it's always other people's parties that you need to watch out for.


    I have seen people do things like that before... I used to hang out with White-Water kayakers who were all a bit... affected... I fit right in. Obviously we had the introverted folks who were pretty quiet and sensible (I was part of that lot)... and then you had the extroverted people who... well they done daft and stupid stuff - often while drunk. It was one of them who nearly lost his finger table-climbing last weekend incidentally xD

    [edit] - correction: he has lost his pinky finger because the surgeon didn't think it was worth attempting to reattach it - just tidied up the base (he severed it just below the knuckle - youch). I look forward to hearing the "alternative" stories of how he lost the digit!

    Speaking of Kayaking... if it's the middle of winter and there's 2 inches of snow on the ground - don't climb a hill naked - you'll slip, land on your didgeridoo, and slide down the hill...

    When you go to hospital (having slipped and landed on your didgeridoo) - I don't care how sore it is - at least have the decency to wear more than just a coat!

    ...and of course, somebody will have filmed the entire incident on their phone - but you won't find that out until they show the footage at the annual film night.
     
    #3911 MadScience101, Mar 9, 2017
    Last edited: Mar 10, 2017
  13. netsuke

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    If you're bothered by arthritis in your knees, call your doctor to request a prescription for the glycerine and Cogentin your friend recommended.
     
  14. evangeline1313

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    If your high blood pressure is controlled by medication, that doesn't mean you don't have high blood pressure.
    I've only talked to maybe 20 patients so far and it already happened 5 times.
     
  15. Aquar1us

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    Why did the surgeon not reattach it? One's fingers are kind of important I'd think. If it was completely destroyed, that'd be one thing...
    Also, landed on his didgeridoo?? I shudder to think exactly what you mean by that :whoa:
     
  16. meep15

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    Working as an EMT has reminded me that everyone lies (or have selective memory recall)

    For example:

    "I have no medical history" - yet has a cabinet full of pill bottles

    "I have no medical history" - No doctor ≠ No history

    "I always take my meds on schedule" - (BP295/130)

    "My back pain is 11/10" - Asks for "that drug that starts with D"

    "I've never taken drugs, EVER!!" - Insert Maury meme: The Narcan determined that to be a lie

    "I slipped and fell on it." - Mystery rectal trophy

    "I keep good control of my blood sugar" - "hI"

    "I only had two beers" - s/p MVA, reeking of alcohol
     
  17. BoardingDoc

    BoardingDoc Don't worry. I've got my towel.
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    There is a long list of things which make a replant not feasible. Replanting an amputated digit is far less common than simply doing a revision amp.
     
  18. DissocativFugue

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    Changed it for ya. Everyone's favorite quantity of beer.
     
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  19. Aquar1us

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    People already made these memes :D
    [​IMG]
    [​IMG]
    [​IMG]
    [​IMG]
     
    #3918 Aquar1us, Mar 11, 2017
    Last edited: Mar 12, 2017
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  20. SpartanWolverine

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    Chewing on a fentanyl patch is a good way to earn yourself some Narcan. When you rapidly come back from the brink of death and get angry with us for giving it to you, we're not going to feel particularly bad.
     
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  21. MadScience101

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    Im afraid I'm unaware of the details - I didn't accompany him to hospital. On the other hand, one of the ladies he was trying to impress did accompany him to hospital - so maybe it wasn't all bad.

    The break was pretty mangled looking (he had crushed it off with the table edge (assisted by having his full weight on the table at the time) - there's probably a fancy name for a traumatic amputation by crushing - but I'm unaware of it!) - but I don't know if that was the main reason why they didn't reattach.

    I'm personally quite attached to my pinky-finger - if I must lose a particular finger, take my ring finger - it's not useful for holding stuff... seriously, try using a hammer while lifting your pinky off the handle - it's really hard. Repeat with each of the other fingers for comparison.

    As for landing on his didgeridoo... I refuse to clarify on the grounds that I might incriminate myself... 'nuff said

    Any idea why patients lie so much? I've encountered it myself several times just from witnessing events - now to be fair, there are some times when I can imagine lying about - such as how that cucumber got stuck up there (I mean, who want's to admit that they were climbing a ladder naked when the accident happened? I'd much rather lie and say I wanted some rectal adventuring than admit to my stint in the naked fruit cirque de solei)

    Might be a subject for another thread actually, in fact it's probably been done already and I've just not bothered looking for it! xD
     
    #3920 MadScience101, Mar 13, 2017
    Last edited: Mar 13, 2017
  22. Aquar1us

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    So it is you! YOU are the Rectal FB Bandit! You sneak in under people when they're naked hanging from slopes or ladders, you move any nearby cucumbers or didgeridoos and then people land on them! And then you sneak away you scoundrel.
    Then people say mad sounding stuff like 'somedude moved the didgeridoo there so I landed on it'.
    :sour:
     
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  23. MadScience101

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    Thanks! I've been having a pretty terrible day and that has cheered me up no end! :D
     
  24. Aquar1us

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    Happy to be of service ;)
    Anyway, you've struck again haven't you? Lookit that satisfied grin. And removing the radiopaque tag, of all things :sendoff::cold:
     
  25. Spectre of Ockham

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    If you are a 63 year old woman and you just had "the biggest diarrheic BM of my life" at 2:40 AM without any other symptoms the right thing to do is to rush to the ER , there triage will make you wait until 4 AM. After I do a basic exam and history (PT took two high strength Imodium pills) proceed I'll show you to my attending (I'm just a med student) who will promptly ask you if you ever had diarrhea before and how did you survived it in the past 60 years without rushing to the ER at 3 AM.

    When asked what you took in order to sound smarter tell the attending that you took two antidiarrheic edemas. I will then be forced to rush to a camera blind spot so I can laugh silently while the attending puts on the biggest poker face in the universe and questions Darwin for the 8th time during one week.
     
    #3924 Spectre of Ockham, Mar 14, 2017
    Last edited: Apr 29, 2017
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  26. MadScience101

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    Im not sure how to put this into a concise-lesson format...

    So I'll just tell the story. Had a cracker (and possibly a crack-head) on the bus on the way into work this morning.

    Bus driver gets out the cab and goes upstairs (double-decker bus), drags some stoner out for not paying his ticket.

    The stoner then claims "They took his ****ing keys so he cant ****ing get in the ****ing house to get his ****ing jacket or his ****ing money and I have to be at the ****ing court for my ****ing parole appeal" -- the bus driver tells him to GTF off his bus.
    +pity+


    After finally getting him off the bus, he comes back on shouting about how he "had to ****ing rob the clothes he's wearing off some ****ing washing line!"

    This raises several questions:
    1) What was he wearing before he stole the clothes?
    2) It's been pretty wet here the last three days - how long ago did he steal these particular clothes?
    3) Who are "they" [the people who "took" his keys/clothes]?
    4) If you had to steal clothes, did you steal underwear too or are you going commando?



    Now you may be wondering what exactly I learned from this patient, and how exactly he even became a patient?

    Well, after his outburst... he angrily turned around to go off in a huff... and stormed straight into a lamppost: fell on his backside, and sat there for a bit while the driver pondered what to do.

    The funny thing is that as soon as the driver called an ambulance to come pick him up the guy got up, shambled over to the bus again and asked for a ticket to the hospital - and even proffered money for it - WHY DIDN'T YOU DO THAT IN THE FIRST PLACE!?

    Also, apparently the bus services aren't allowed to transport obvious A&E patients to A&E (he had an imprint of a lamppost on his face - I didn't even know tissues could swell up so much in such a short period of time!) - just in case the patient passes out / dies / gets worse en route.

    They are under obligation to wait for the ambulance to arrive though - I learned many things from this experience!

    -Don't be stealing clothes from washing lines on rainy days/weeks because "they" took your keys so you can't get into your house to get the money to go to your parole hearing at the court at 0600, especially if you do actually have money anyway.
    -If you're going to dramatically turn around and storm off, make sure there isn't a lamppost in your way.
    -Busses aren't allowed to act as ambulances
    -Your face can swell up so much that you look like a cartoon character in only 15-20 minutes (wasn't keeping track)
    -You can be thoroughly annoyed at being made late to work - but at the same time be thoroughly amused as to why you're late to work...
     
  27. Aquar1us

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    Smooth. Real ninja...
    Wondering what exactly I learned, by pondering whether he's wearing stolen underwear, or none at all..?
    Real Ninja don't need it!
     
  28. Aquar1us

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    Today, in an NHS hospital setting, I witnessed a 'sectioned' man (what a psych hold is called in the UK) yelling at the staff: 'I've got superpowers and I'm not afraid to use them!' But in the end he didn't, and did not get what he was demanding (to be released) :(
    Lesson learned: if you've got superpowers, don't be afraid to use them!! Only then you may get what you want ;)
     
    #3927 Aquar1us, Mar 18, 2017
    Last edited: Mar 18, 2017
  29. MadScience101

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    If you get an inch-long shard of metal stuck under your skin while working at a fabrication plant and it's too sore to pull out with tweezers, just leave it in there - it'll come out itself, right? right? Im sure those abscesses will clear up on their own!

    Whoops! It's
    Bacteremia-o'clock!



    If you end up losing a carrot in your butt, try to blame it on the house search the police performed the week before - those always involve butt-carrotings!

    Whoops! It's Sore-bum-o'clock!



    No, I can honestly say that I would have stopped trying to use the hammer once the head of the hammer broke off the shaft. STOP - no more hammertime.

    Whoops! It's MC-Hammer-o'clock! NB: MC stands for "metacarpals" in this case.
     
    #3928 MadScience101, Mar 28, 2017
    Last edited: Mar 28, 2017
  30. SouthernGent

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    Don't put your eye close to the drywall when your buddy is on the other side putting in 3in nails with a nailgun.

    Don't put both of your very hot crackpipes in your vagina and to try and hide them from the police.

    Selfimmolation is not the fastest and least painful suicide method, especially when you consider the near total 3rd degree burn coverage and (eventually) fatal infection you'll acquire in the burn unit.
     
    #3929 SouthernGent, Apr 16, 2017
    Last edited: Jan 19, 2018
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  31. bbpr120

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    With your dominant arm lying in the street (along with a leg) after having it removed via a street sign in car v motorcycle accident and medics furiously trying to stop you from bleeding out; make light of the situation by saying that the hardest challenge in front of you is learning how to masturbate with the wrong hand.

    A good friends younger brother was critically injured last week on his motorcycle when a truck pulled out in front of him and he clipped a street sign on his way down. He spent the entire trip to the trauma hospital cracking dirty jokes according to mutual connections and didn't stop till he was knocked out for surgery. Outside of 2 missing limbs, he's gonna "walk" away with only some road rash.
     
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  32. MadScience101

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    I learned that tennagers shouldn't climb lampposts at 0200 on a Sunday morning.

    Apart from the obvious streetcred from hanging off a steel post 8m (26ft) in the air - you wont be able to get back down yourself.

    Your friends will fetch a ladder, set it to the wrong length, prop it up against the lamppost and send the largest guy in the group up to help you: this will cause the streetlight to suddenly bend, throwing you 8m (26ft) to the ground where your pelvis will pop like a party balloon.

    (Loudly) blame the guy they sent up the ladder for your current predicament. It's definitely his fault.

    Oh, and you'll also get charged for stealing that set of ladders, and for a new lamppost.

    Continue blaming your friends for this - especially the guy they sent up the ladder.

    It's totally their fault - but the streetcred was worth it.
     
  33. swoopyswoop

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    Maybe I'm old and grumpy, but this thread is intended for medical professionals to post their stories, not for random people to post stories they think are amusing but which are not really relevant.

    The point is that we find things amusing from a different perspective than you recounting your night in the ER or your friend's trip in an ambulance.
     
  34. Perfect Hair Day

    Perfect Hair Day Lady Killer.
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    Wait why what happens if you do this?
     
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  35. Kittenmommy

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  36. Aquar1us

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    OH that thread
     
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  37. elcollins95

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    Saw a pt recently who non-traumatically dislocated their shoulder "washing dishes" (?!)
    The cocktail of drugs we ended up giving after NOx failed meant that our pt was more than a little stoned.

    The lesson?
    The appropriate response to 'how's your shoulder feeling now?' is not 'much better thank you' but:
    "I can't feel my shoulder, you must have stolen my shoulders! I can only feel my toes, don't steal my toes!" while sobbing hysterically.
    Other gems included (to the nurse) "You have no noooossse!" and "You have eleven eyes!"

    We all had to take it in turns stepping out to giggle at the poor patients 'stolen shoulders'. The best part was they work within the hospital so they will never forget about their antics!
     
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  38. theseeker4

    theseeker4 PGY 3
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    If you have BPH and are suffering from urinary retention, and you have failed to void all day, the reasonable solution is right there in your kitchen. Don't waste time by going to an actual doctor, just grab a drinking straw and thread that baby up your urethra. True, you might have some issues with the 90 degree turn a few inches in, but don't let that keep you from trying. The pain and bleeding is also perfectly normal.
     
  39. CajunMedic

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    If you are a diabetic washing off after a long day in the oilfield, it's perfectly OK to use the industrial pressure washer to wash the mud, drill fluid, etc. off of your boots, be sure to leave them on. And when you accidentally spray the leg point blank with said pressure washer, wait almost 24 hours until the leg swells up and starts oozing to drive yourself to the ED. The gas pattern from the necrotizing fasciitis looks real pretty on X-ray and will buy you a high-speed trip to the OR. They hung antibiotics I'd never heard of today and are pondering a second trip to the OR in the AM.
     
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  40. PDXErik

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    This thread just got $90 worth of pizza delivered to my nearest ER/ICU

    Just a head's up, Godfathers discounted it by %50 just for you folk.

    <3 you all

    Also, I did try to send it from "that guy" just SOCMOB, don't know if that will make it to the end, tho
     
  41. PDXErik

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    This is pt taking it in humor the same way you guys do. Gotta have some props for that.
     
  42. PDXErik

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    Just a head's up, I blew $50 on $90 worth of pizza that is sitting on a cart in triage just getting cold. Drop shipped from Godfathers. The staff was uncooperative in trying to get these pizzas to where they should be.

    So, Providence Medical, BVTN, yall didn't get pizza, but that's not my fault for trying.
     
  43. SpartanWolverine

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    Thanks for thinking of your local hospital staff. It's super nice when people make gestures that show appreciation for the hard work that gets done. Sorry it sounds like it didn't end up working out exactly like you hoped, but hopefully it ultimately made it back to the staff room. Cold pizza is still good pizza!
     
  44. CajunMedic

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    That apparently you can have pertussis, even as a vaccinated adult (apparently he got sick while in the Army). But more important this visit is the barking seal cough and stridor. Do a soft tissue neck X-Ray, classic steeple sign. So not only has my middle-aged patient had pertussis as an adult, he now has croup as an adult. Got some nebulized Lidocaine for that one.
     
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  45. Lovelace09

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    Non-medical person here, but grew up with my mother in a medicine-adjacent field and got to hear a few good ones. I enjoyed reading this thread so much that I thought I'd pass on one of hers and one from the patient's end of things.

    From my mother, who did her PhD in medical applications of educational technology and spent most of her degree dealing with the faculty of medicine: No, Google Translate is not a massive leap forward in patient-doctor communication. Thankfully, the genius PhD student who came up with that breakthrough decided to ask my mum to help him test it before he brought it to the ER where he works.

    "Hey, do you speak any languages other than English?"
    "A bit of French, why?"
    "I had this idea. Can you help me test it? I'll be using it in the ER, so..."
    Input: <I'm sorry, you are dying.>
    "Alright, does the French look right?"
    Output: <Je m'excuse, tu es mort.>
    "It says 'excuse me, you're dead'."
    --

    And one from the patient's perspective: If you had emergency surgery due to a lodged kidney stone, and were informed that there was one still in there that the surgeon didn't manage to get, here is what not to do. Wake up noticing that you're experiencing the exact same symptoms as last time, and since your cousin told you he passed a kidney stone at work once you should just start taking the leftover heavy-duty painkillers from the first surgery and keep going about your business as usual. Don't tell anyone this is happening. After all, it's only a few weeks before Christmas, your mother-in-law is in town for the holidays, you hate hospitals and your wife and daughter are both worriers. Schedule an appointment with your family physician in a few days to make sure it isn't anything really serious and go about your business. Walk to work when it's 30 degrees below freezing because you know not to drive with the painkillers.

    Then act completely shocked when your GP freaks out, gets you on the phone with the surgeon from the last time you had this problem (who happens to be the only person in the city at the time qualified to do that particular surgery), and instructs you to show up to the ER where that specific surgeon works first thing the next day with a note from your GP, the surgeon will try to fit you into his schedule. He goes on Christmas vacation the next day, so if you don't get surgery that day you will need to be airlifted to Vancouver. All because you don't like hospitals and put off a visit for two weeks for an issue you knew could need emergency surgery because you've already needed emergency surgery once for that exact issue.

    My dad is a really smart guy most of the time, but he can be a colossal idiot sometimes.
     
    #3944 Lovelace09, Nov 23, 2017
    Last edited: Nov 27, 2017
  46. Cardinals

    7+ Year Member

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  47. borderlineinCle

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    I thought this is why all pregnant women get vaccinated and why TDaP is recommend once as an adult as a booster instead of just TD q10y because immunity wears off for pertussis?


    Sent from my iPhone using Tapatalk
     
  48. Aquar1us

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    ...am I a bad person for laughing as inappropriately hard at this as I did?
    Those links are a goldmine. My personal faves from there:
    If it’s Christmas, it must be time to learn what America shoved inside itself. The only worthwhile holiday tradition pushes on.
    All reports are taken from the U.S. Consumer Product Safety Commission’s database of emergency room visits, and they are occasionally not for the faint of spirit. If I may offer one universally good piece of advice, it would be to make sure the base is flared.
    As always, objects are sorted by orifice, working south:
    Ear
    BREAD
    BATTERY
    “STUFFED PAPER TOWEL IN EARS TO ACT AS EAR PLUGS BECAUSE ROOMMATE WAS SNORING, UNABLE TO GET IT OUT OF EAR”
    PUTTY
    A BEAN
    “GASOLINE IN LEFT EAR WHILE CHANGING FUEL FILTER”
    PENCIL SHAVINGS
    RAIN WATER
    TWO STICKERS STUCK TOGETHER
    “GOOGLY EYE INSIDE HIS RIGHT EAR, AND ANOTHER THROUGH NOSE”
    Nose
    CANDY WRAPPER
    “SHOVED PLASTIC TOY UP IN BOTH NOSTRILS”
    GUM
    PINK BALLOON
    “PLAYING WITH A DIME ABOVE HEAD AND LOOKED UP WITH COIN FALLING INTO NOSE”
    “STUCK HAIRPIN INTO NOSTRIL TRYING TO CLEAR BLOOD CLOT FROM NOSEBLEED”
    FISHTANK GRAVEL
    ONE MAGNET IN EACH NOSTRIL
    Throat
    OPEN SAFETY PIN
    “SWALLOWED STAPLES BECAUSE ‘ALIENS TOLD HER TO’”
    AQUARIUM THERMOMETER
    “SWALLOWED A PEN BECAUSE NO ONE PAID ATTENTION TO HIM”
    “A GOLDEN SHINY PENNY”
    CONFETTI
    “FOUND AFTER SWALLOWING 1/2 PACK OF GUM IN ROOM AT HOME, EMPTY WRAPPERS EVERYWHERE”
    “INJURED AFTER EATING CHARGING END OF CELL PHONE”
    “SWALLOWED 3 PLASTIC PUSH-PINS IN A DARE AT SCHOOL, WON $15"
    Penis
    A LITTLE SCREW
    A SHARP TOY
    FOUR INCH LONG METAL SEX TOY
    PLASTIC SPOON
    PIECE OF DOMINO
    PIECE OF PLASTIC SHAMPOO BOTTLE
    “PUT PAPERCLIP THROUGH URETHRA AND PUNCTURED THROUGH THE SHAFT OF PENIS”
    COAXIAL CABLE
    Vagina
    “WAS CLEANING SELF IN SHOWER WHEN FOUND A TAMPON IN VAGINA. CONCERNED THAT THERE IS ANOTHER TAMPON IN VAGINA”
    SILICON BALLS. PATIENT STATES IS FOR “YOU KNOW, FOR WHEN YOUR HUSBAND LEAVES TOWN”
    BIKE REFLECTOR
    HEADPHONES
    HOT TOWEL
    “WAS HAVING SEXUAL INTERCOURSE WITH BOYFRIEND WHEN HE PUT PHONE AND MONEY IN VAGINA”
    CLAY
    LOLLIPOP
    “USING MASSAGING URETHRAL VAGINAL STONE BALLS & THE STRING HOLDING 15 BALLS TOGETHER DISSOLVED, CAN ONLY FIND 14 BALLS”
    TOY MAGIC WAND
    Rectum
    PEANUT BUTTER JAR
    CURTAIN ROD
    “STUCK A TOY UP HIS RECTUM BECAUSE HE THOUGHT HE WAS CONSTIPATED”
    TOOTHBRUSH
    TOOTHBRUSH HOLDER
    “AT A PARTY HAVING FUN WITH HIS MALE FRIENDS WHEN ONE PUT A SHOT GLASS UP HIS RECTUM”
    SMALL WOODEN KNICK-KNACK
    TOY MISSILE
    PLASTIC VIBRATING DILDO, CAN NOT TURN OFF
    “ATTEMPTED TO DISLODGE A DILDO FROM HIS ANUS USING A LETTER OPENER”
    CIGAR TUBE TO RELIEVE HEMORRHOIDS
    “FEELING LONELY, USED A MASCARA CONTAINER IN PLASTIC BAG, PUT IN RECTUM”
    “WAS DRINKING WITH FRIENDS AND ‘GOT TO EXPERIMENTING,’ AIR FRESHENER CONTAINER STUCK IN ANUS”
    MARBLES
    BAG OF ORAL TOBACCO
    “WATER BOTTLE IN RECTUM, DOES THIS TO REDUCE ANXIETY”
    3 AA BATTERIES
    2 AAA BATTERIES
    D BATTERY
    “PATIENT SAID I HAVE A COIN IN MY ASS FROM A MONTH AGO”
    OK, so you’ve already learned about all the things we shoved inside ourselves last year. But what about our dangly bits? Rest assured, we punished them.
    All patient descriptions taken verbatim from the U.S. Consumer Product Safety Commission’s database of emergency room visits:
    GRABBED BB GUN WHILE WRESTLING AND GOT SHOT IN PENIS
    FELL DOWN STAIRS WITH A STICK FROM A TREE. HE HAD SHARPENED IT INTO AN ARROW POINTED END- STICK LANDED ON SCROTUM
    MASTURBATING WHILE TAKING ON TELEPHONE WITH GIRLFRIEND, CRACKED HIS PENIS
    MASHED HIS PENIS BETWEEN CAR TRUNK AND LAWN MOWER
    DRIVING GO-CART, STRUCK CLOTHESLINE, STRIKING SCROTUM AGAINST SHAFT OF STEERING WHEEL
    PENIS SHUT IN DRESSER DRAWER
    PLAYING WITH CAR TOY PENIS CAUGHT IN WHEELS
    HIT IN SCROTUM THIS MORNING BY CORNHOLE BEAN BAG
    STEPPING OVER DOG GATE AT IN-LAWS’, MISSED STEP & CAME DOWN ON GATE ON TESTICLES
    CAUGHT SELF ON FIRE W/ CUTTING TORCH. DX: SECOND DEGREE BURNS TO SCROTUM, PENIS, PERINEUM.
    PLAYING WITH A KNIFE AND SUSTAINED A PENIS LACERATION
    A ROCK WAS THROWN FROM A LAWN MOWER WHILE BROTHER WAS MOWING LAWN & PATIENT GOT HIT IN THE PENIS
    LACERATED PENIS ON WRISTWATCH
    PENIS PINCHED IN A BI-FOLD CLOSET DOOR
    FELL INTO FAN CAUSING LACERATION SCROTUM
    PUTTING ON PANTS THIS MORNING TOO QUICKLY, SCROTAL BRUISE
    SCRATCHED HIS PENIS ON A PLASTIC BOTTLE WHILE TRYING TO URINATE IN IT
    JUMPED INTO A SWIMMING POOL LANDED ON TOP OF ANOTHER KID CONTUSION TO PENIS
    FILLING UP INFLATABLE POOL, USING HAND PUMP, PATIENT STUCK PENIS IN INTAKE VALVE WHILE THEY WERE BLOWING IT UP
    HAVING INTERCOURSE W WIFE, WAS INSERTING HIS PENIS WHILE POSITIONING HIS WIFE WHEN JAMMED PENIS ONTO BED POST
    AT THE GYM CLOTHING GOT CAUGHT IN THE ROWING MACHINE PULLED BETWEEN SCROTUM AND ANUS PER DAD LIKE A “WEDGIE” PERINEAL HEMATOMA
    WAS DANCING WITH HIS GIRLFRIEND & HIS PENIS ACCIDENTALLY GOT CUT ON HER PANTS ZIPPER
    GOT PENIS CAUGHT ON BELT BUCKLE AND POSSIBLY CRUSHED
    PLAYING WITH MOM’S EXERCISE BAND WHEN IT SNAPPED BACK HITTING HIS PENIS
    HAD AN ERECTION AND PULLED HIS JEANS OVER HIS PENIS AND IT FELT LIKE IT BENT
    WAS JUMPING ON BED, PLAYING WITH CHOPSTICKS. CHOPSTICKS WENT THRU SWEAT PANTS AND PUNCTURED SCROTUM
    WAS JUMPING W/ SPATULA IN HIS HAND 1 HR AGO AND JUMPED ON IT SCROTUM LACERATION
    DOING THE “WORM” MANEUVER ON CARPETING WHILE NAKED AND SUSTAINED A LACERATION TO PENIS
     
  49. MadScience101

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    Today I learned that patients can still scream at you through their trach tube...

    It sounds like an ungodly screeching in case you're interested... and yes, it will haunt me for a very long time...
     
    gamerEMdoc likes this.
  50. Steve_Zissou

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    Iron fist?
     
  51. Aquar1us

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    So that's... screaming like the possessed?

    Steve_Zissou - while it probably isn't, is 'Iron Fist' also a reference to the meaning of "Tekken"?

    In other news:

    Case of the month: Honey I glued the kids: tissue adhesives are not the same as “superglue”
    Emerg Med J. 2007 Mar; 24(3): 228–229. Accepted 2006 Oct 23. Luke Cascarini and Anand Kumar

    Abstract:
    A case of a father who treated his child's facial laceration with the home supply of “superglue” having been previously misinformed that superglue is used to treat lacerations is presented. The differences between tissue adhesive and superglue are described and suggest that emergency staff should be careful to avoid using the term “superglue” when using tissue adhesives.
    An 8‐year‐old boy was referred to the maxillofacial team. He had presented to the emergency department the day before with a laceration to the right brow, which had been glued by his father that day with his own “superglue”. The boy's father had himself attended the emergency department earlier that year with a forearm laceration, which had been glued with what he was told was superglue. As this had been effective, he had decided to use his own superglue to fix his son's laceration to save them from the bother of going to the emergency department.

    On examination, the wound edges were not satisfactorily opposed, and there appeared to be glue within the wound (fig 11).). It was, therefore, decided that the wound would have to be explored under a general anaesthetic.

    Figure 1 The right brow showing the glued wound.
    [​IMG]

    It was found that the wound extended to the periosteum, and the glue was present throughout the wound. There was evidence of active inflammation in the wound.

    The wound was cleaned, irrigated and sutured in layers. The child made an uneventful recovery. The father was informed of the differences between superglue and tissue adhesives.

    Cyanoacrylate adhesives were invented by Dr Harry Coover of Kodak Laboratories when he was trying to make clear plastic suitable for gunsights.[1] These were methyl‐2‐cyanoacrylate and were found to be tremendously strong. These and similar short chain cyanoacrylates experienced commercial success and became generally known as “superglues”. In the 1950s and 60s, methyl‐2‐cyanoacrylate adhesive was used to bond skin and control bleeding in open wounds. Disposable cyanoacrylate sprays were used to control haemorrhage in the Vietnam War. However, it became apparent that methyl‐2‐cyanoacrylate provokes acute and chronic tissue reaction. They also cause histotoxicity because of the exothermic nature of the polymerisation reaction of these short chain cyanoacrylates. Furthermore, they generate local high concentrations of breakdown products, which include formaldehyde and alkylcyanoacetate.[2] As a result, compounds were developed that were more compatible with human tissue. These used monomers with longer alkyl chains, which owing to their slower degradation, cause less histotoxicity. These are used for wound closure and embolisation. They can also be used as dressings for burns, minor cuts, abrasions and mouth ulcers. They have been shown to provide a waterproof antimicrobial barrier and improve epithelialisation and wound healing.[3]

    They are, therefore, quite different from superglues and much more expensive to produce.

    Proper use of cyanoacrylate tissue adhesives for wound closure:

    1 Wound should be in horizontal plane to prevent run‐off.
    2 Wound should be clean and dry, haemostasis essential.
    3 Wound edges opposed with only minimal tension.
    4 Deep dermal sutures may be necessary to take tension off wound edges.
    5 Adhesive applied to opposed edges to act as bridge across wound.
    6 Do not get adhesive into wound.
    7 Do not tell patient you are using superglue.
     
    suberogator likes this.

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