Wednesday, July 21, 2010

The Little Things

Where I work is action all the time. Today I intubated 2 people, 1 central line, sent 3 to the ICU, 1 chest tube, etc. But sometimes it's nice to get one of those classic cases that are simple, but offer the patient relief. Here are a couple of examples

1) A 76 year old female came in with severe dizziness. It had been getting worse over the last few weeks. Immediately all the bad stuff started going through my head like stroke, electrolyte imbalances, etc. But when I looked in her ears...look what I found!

She said she thought she lost a cotton swab Q-Tip about a month ago. Looks like I found it. Treated her with some antibiotics and she should do fine. Probably the only 75+ year old I have been able to send home with dizziness.

2) A mom brought in her 18 month little girl in for a "red eye." Mom was convinced it was pink eye. Not a bad thought, but when I looked at the eye, I saw no signs of pink eye. Her eye was red, but just didn't look like conjunctivitis. And she was kind of guarding her eye with her hand. So I told the mom I wanted to stain the child's eye to make sure she hadn't accidentally scratched her cornea, causing a corneal abrasion. The mom thought I was crazy, and it took a lot of convincing for her to allow me to do the exam. Low and behold, this is what I found! (Similar image from online. Not actual image from patient didn't want to make her have to take a picture after her enduring me staining her eye for the exam)

Corneal Abrasion

Poor thing probably scratched her eye with her nails. She should do fine as well.

Neither case was exciting, but they weren't everyday things for my practice and they offered patient's actual treatments with good outcomes. In a very high acuity ER, this is nice.

-ER Doc


G-31 Toastmasters said...

Glad your LOL didn't have anything worse than a lost Q-tip top. Even just plain vertigo can be miserable, let alone the worse causes of dizziness.

My child had one of those corneal abrasions. Ouch! When Doc did that green light there was a big half-moon shape where child's fingernail dug right into the cornea. Ugh. Antibiotic stuff and a pirate's patch for a few days and no long term effects. Thank goodness!

Classof65 said...

I know I'm getting old and my eyesight isn't what it used to be, but the print on your site is so tiny that I can barely read it! I checked View, print size, and it's set at largest -- so what do you suggest I do??? No, please don't take this opportunity to tell me to talk a long walk on a short pier!

Rachael said...

class of 65- dunno what browsing you are using. but on firefox, to increase text size- ctrl + +

Classof65 said...

Ahhhhhhh! I am so dumb! I complained to my husband about the text size and he looked at the bottom of the screen and said, "Well, I don't know how it happened, but it says it's only 40%"and he clicked on it, changed it to 100% and now we're back in business.....

Thanks, Rachael, for trying to help me. Maybe I'm beyond help...