2 Visits For The Price Of One ? Nope!

Psych Doc mentioned he would be posting an addendum to fill in the gaps for his previous post. But basically, whenever a psych patient gets violent like that, he must be restrained. At some point during that process, the patient apparently coded (which resolved quickly and allowed him to continue with his terror on the staff). Anyways back to my post......



A 54 year old male came in for a deep laceration to his leg. It needed to be repaired, obviously. But before I was allowed to do the repair, the patient demanded to get a "price quote." It was an unusual request, but we obliged and came up with a quote.

When he heard the price, he became very anxious and upset. He then developed chest pain, nausea, and diaphoresis. We quickly got an EKG, and sure enough he was having a heart attack. He got so worked up over the price of the lac repair that he had an acute MI!

I didn't tell him how much the price of his visit was going to skyrocket on his way to the cath lab.....

-ER Doc

'Twas the night before the night before Christmas

This is a true story. Once upon a time on the night before Christmas Eve, a few days ago, ER doc and I exchanged some texts that prove that the karma police don't take the holidays off.

What follows are a chain of events and text messages that I couldn't make up if I tried. This occurred at a psych moonlighting gig. Text messages are exactly as written that night.

11:43 p.m. Psych doc gets paged about a verbally agressive antisocial patient who is threatening to kill the staff's families and their children over a candy bar. Psych Doc orders emergency medication.

11:48 (text from ER doc): I'm working tonight and next 2 also if u get bored.
11:49 (text from psych doc): Im on tonight but i am done with admits. Gonna go sleep now. Knock on wood, hoping for no seclusions.

(note: if there is a seclusion, I have to get out of bed and go see the patient.)

11:51 (text from ER doc): Sleep work. Lucky
11:55 (psych doc): Thats psych for ya. Pretty cool til somebody codes and I sh!t myself.
11:58 (ER doc): U can call me

( I go to the call room, brush my teeth, take a leak, set my alarm. Close my eyes.)

12:11 am (I get a call from the same unit above, about the same patient.)
(psych doc) Right on cue a patient just stabbed a tech with a pen.

12:14 am (ER doc): Hahaha

Between this time and 2 am, I sent 2 techs and the patient to the hospital. The patient coded, or else he was faking it really good. I don't think the AED would lie. Either way, I somehow managed to keep my britches streak-free and everyone else alive. The patient was critical and was admitted.

02:14 am (psych doc): (Expletive)
02:16 (ER doc): what happened

I recounted the past 2 hours, 160 characters at a time, to my ER colleague 60 miles away.

02:20 (ER doc): Thats crazy sh!t man. I feel sorry for you. You gotta blog it though, its hilarious.

Lesson learned, for like the 100th time; don't say how quiet it is, or how likely you're gonna get some sleep ANY night you're on call. Karma, God, Buddha, Santa, or somebody is up there waiting to get you.

-Psych Doc

The Lost Tampon

A 24 year old woman came to the ER because she couldn't find her tampon. She stated that 3 days earlier her and her boyfriend "got trashed" to celebrate his birthday. She was on her period and didn't want to have sex (I agree with that notion btw).

The rest her story is kinda sketchy. She states she doesn't remember anything from the night after that. She realized a couple of days later that she couldn't find her tampon.

I don't have a vagina, but I would guess a tampon is something that you check on and replace regularly. Anyways, she started interrogating her boyfriend, and he admitted to having sex with her the night of his birthday while she was drunk and basically unconscious.

So she really came to the ER because she was afraid he "rammed it up there."

Sure enough, he did. In the back of her vaginal vault was a rotted, crumpled up, disgusting tampon.

-ER Doc

White People

Let me preface by reminding everyone I am Puerto Rican.

Yesterday at about 9 AM I had a very drunk African American Female come in after falling and bruising her ribs. I refused to give her narcotic pain meds since she was drunk, and of course she threw a fit.

As my nurse (who was an older very black woman), and myself (a tan Puerto Rican) were attempting to discharge her, the patient shouted "YOU WHITE PEOPLE ARE ALL THE SAME."

The nurse and I both looked at each other to make we we hadn't lost our natural colors, shared a laugh, and I replied "Ma'am, there isn't a white person in this room!"

Imagine being that drunk on a Tuesday morning.

-ER Doc

Bite Me

Apparently postal workers aren't the only profession that have to worry about getting bit by dogs. A young, obese, female pizza delivery worker came to the ER after getting bit in the ass while delivering the pizza. After handing over the pie, the dog chased her to her car and grabbed a chunk of her butt steak. I wonder if the family had trained the dog to do this to get out of paying for deliveries.

-ER Doc

Medication Reaction

All, welcome our newest blogger, ER PA. He is a physician assistant in our ER, and put's my writing vernacular to a shame.

------------

I was working the 12p-12a shift in the ER and grabbed this fateful chart at about 2230. As the chief complaint, it read "Pt states he is having a medication reaction." African American male in his 20's, taking Flagyl for a trich infection.

I go into the room and find the patient still wearing his hat sideways, grill in place, dressed in a gown. I introduce myself and ask him, "What kind of reaction are you having to this medicine?"

The patient, looking flustered, stands up ... faces me ... pulls his gown up to his chest ... and declares, "The medication I been takin is makin my penis smaller!!"

"Excuse me?" I reply.

"I took four of these pills last night, and they done made my penis smaller. And every time I'm smokin marijuana, my penis feels weird."

I'm a little ... surprised ... but keep pressing on.

"Did you happen to smoke marijuana before coming in tonight?" I expectantly asked.

"Yeah I did!"

We are having this conversation with his gown pulled up the entire time.

To either appease his fears or give him the benefit of the doubt, whichever, I examin the penis in question.

"Sir, I see nothing wrong with your penis ... and I really don't have anything to compare it to."

"WHAT DO YOU MEAN?!?!" he said angrily, "I CAME HERE SO YOU COULD FIX THIS!! IT'S SMALLER ... AND WHAT ABOUT ALL THOSE WRINKLES!?!?!?!"

At this point, I want to hang my head in shame ... for him!

We then begin to have a conversation about how I have never heard of a medication causing anyone's penis to be smaller, and that I have no treatments whatsoever to make his penis longer.

"Why do you think it feels weird when I smoke my marijuana?"

"Well, sir, smoking marijuana probably doesn't help the situation. You should probably stop."

"Yeah ...I guess you're right. I should probably drink more water too, right?"

"Absolutely sir ... absolutely."

-ER PA

Another Great Mom

It's been a while since we had a World's Best Mom post. Here is another nominee:

A 21-year-old female came in for heroine intoxication. She was 6 months pregnant. She had been abusing heroine most of her pregnancy. She had been in 3 different detox programs, but left them all AMA to go use and abuse again.

The only reason she came in this time was because her grandmother caught her shooting up and called EMS.

I heard her on the phone with her dad...."Are you going to bring me cigarettes up here or not?"

I called our psych team, and they could do nothing for her due to her leaving AMA all the time. Same went for our social worker. All I could do was notify CPS. They already had a case against her.

Personally, I think since she is harming a child she should be legally locked into a room AGAINST HER WILL until she detox's. It won't kill her.....too bad that can't happen.


- ER Doc

Ouch!

(Story and picture are provided from a colleague)

So a 44 year old female was outside in the woods and saw a snake. She wanted to see what kind it was, so she got closer. She quickly discovered the snake was huge....about 6 feet long. She figured it out after the snake JUMPED OUT and bit her.

The damn thing would not let go. EMS brought her in with the snake attached as above. The only thing to do was to get a big ass knife from the OR and cut the snake in half to kill it. That was successful, and the woman was admitted for antitoxin.

Her face will never look the same, and hopefully for now on she won't be so curious.

-ER Doc

Have It Your Way

.....That's at Burger King, not the Emergency Department.

A 64 year old male came in to "have his cataracts taken out." He thought we just had a eye doctor sitting around in the ED waiting to take care of him. When I told him we didn't, he was upset because he would have to make an appointment with an eye doctor, wait for the appointment, and pay money for it! The audacity!

I have had multiple similar encounters with people wanting there breast lumps taken out and diagnosed for cancers, colonoscopies, and even skin biopsies. Emergency department folks, emergencies only please.

-ER Doc