Saturday, August 14, 2010

Friday The 13th

Wow....what a Friday the 13th for our department. Not all of the cases below were my patients. Some were from my co-workers, including the lost blogger Doc Sensitive.

-Epiglottitis in a 40 year old male. This is a pretty rare diagnosis, and can be deadly. Follow the link for info about it. The on call ENT doc ended up coming in to intubate him.

-A 23 year old was shot in the chest at around 5pm and killed. We intubated him, put in bilateral chest tubes, and contemplated cracking his chest open but there were no signs of life.

-A 43 year old came in with angioedema. He got progressively worse. ENT felt like they had done their on call duty for the day from case #1 and would not come in. So for the first time, I did an awake nasal intubation with a fiberoptic scope. Scary shit but it worked.

-No shortage of the intoxicated patients. One was 24 years old who had her 5th child 2 weeks prior. She was horribly intoxicated screaming profanities about her children. Besides being drunk, she was positive for cocaine and marijuana. She couldn't even complete a sentence. "Dad" said all she does is I called CPS and sent her to a psych facility for postpartum depression. Who knows if she was really postpartum depression or just a low life, but I felt if I just let her sober up and go home....that by the time CPS showed up one of those kids would be dead.

-A 68 year old female with fibromyalgia who felt "anxious and stressed" after spending the night at a church lock in. WTF ?!?

-A 41 year old female that was soooo fat she could not take care of herself and had to live in a nursing home. Disgusting. Now for all your purists....she had NO medical reason to be this fat. She came in with shortness of breath....b/c she was literally TOO FAT TO BREATH. She ended up in the ICU

-Ended the shift with an average stab wound to the chest. Those "two dudes" were out again last night I guess, as they stabbed this poor patient in the chest as he was walking back to his car leaving the club minding his own business. He did fine, but if anyone can locate these two dudes (they have popped up in older posts), please notify your local authorities.

ER Doc


ERP said...

WTF? The ENT would not come in for angioedema that required intubation? He had to deal with epiglotitis earlier in the day? So what? That's your damn job! Life sucks. Deal with it!
Actually, the last case like this I called anaesthesia who did the nasal intubation - but ENT was on their way in since I was ready to cric the woman.

SerenityNowHospital said...

It was midnight. U gave him the it's your job bit. He said never in his career has he seen a angioedema need to be intubated. To just give decadron and protonix. We both know that's BS. I've crich'd 2 last year. So I had anesthesia on back up and the crich kit ready, but really wanted to do it myself.

I forgot I delivered a baby too. I need to add that to the post

arzt4empfaenger said...

Wow, you sure were busy. Good on the intubation (I was wondering about anaesthesia, but if you had them in the backup, perfect).
When I was working nightshifts in the sleeping lab, the doc kept telling people with sleep apnea that losing weight would often help alleviate the problems. They just didn't want to believe it. using a mask was easier. In my anaesthesia practical work in rural Germany, we saw a lot of huffing and puffing people who were simply too obese, too. It's sad when they're so young, too.

PathologyGrrl said...

Ah, those Two Dudes. One night they sent me a guy (who had been on his porch, minding his own business) up whose rectum they had shoved a shotgun. Nice. So glad I'm a pathologist now. :)

Ninjamedic said...

Oh would seem that not only is Sumdood in your town, he's bought a friend along with him.

Sumdood is dangerous; he has the ability to be in many places at the same time. His M.O. is accosting and attacking people who are just minding their own business and trying to live their lives. Every police department in every town has Sumdood on their 'most wanted' list, and if he ever gets caught Sumdood will surely spend the rest of his life in jail because of all the mayhem he's caused.

Look out for Sumdood. He's bad news.

Anonymous said...

'She had no medical reason for being fat'- so what? You are such and a$$hole, truly. How dare you judge someone like that.

rnraquel said...

What a slack ass ENT. I am glad that you and anesthesia were up for it. Good job!
We have a 20 something patient in our ICU right now who is trached and getting almost daily debridements of pressure ulcers in the OR. When I heard of her, I asked paraplegic, quadraplegic, stroke? No...morbid obesity. Damn.

Jules said...

Hey anon, who gives a shit if he "judged" her or not? She was treated, wasn't she? Now shut up and go finish your big mac.