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25 November 2009

When Art Imitates Life, Exactly

One of my colleagues posted this on Facebook, and I am sad to say I am sure someone stood outside the Emergency Department room while I interviewed a patient.... seriously....

Today a mother presented with her teenage son and said she wanted him tested for the Swine Flu and a prescription for Tamiflu. When informed that we don't routinely test for the flu and that Tamiflu was only for those at high risk showing symptoms (which her son was not), she told my attending she wanted to speak to his supervisor. When he informed her he was the senior medical staff, she told him that she was in the medical profession (a secretary at a nursing home) and no one was going to fool her like they did everyone else, and that she wanted a second opinion. He told her she could check her son back in and be seen again. But, she had a 50/50 chance of seeing him again.

She then stated she wanted to talk to a supervisor, and she demanded a second opinion. She saw the nursing supervisor who advised her to go to her child's pediatrician which just happened to be at the pediatric clinic across the street. When my attending called over to warn them that she was coming over, he was told that she had already been there and that they had told her the same thing. Last we heard, she was on her way to get a third opinion...

22 November 2009

Bang Your Head

Ok, so it's been a while.... Funny how some shifts just seem to have a theme.  Last night I found out all the different ways that someone could suffer a head injury.  It made for an eventful but tedious shift, and also kept the CT scanner burning away.  I think we all had radiation exposure since 80 percent of the patients that came in from 11 p.m. onward needed a head and face CT.
There was:
 - drunk, fell down and smashed head on concrete 
 - drunk, tripped and fell down hitting face forward on concrete
 - drunk, minding own business, and got whacked on head with metal pipe
 - drunk, minding own business, and got slammed on head with baseball bat
 - drunk, jumped into middle of fight and got hit on head and face with beer bottles
 - doing cocaine and got hit by several people's fists across the face
 - got drunk, drove without a seatbelt, crashed into several cars, jumped out and ran for about a mile from police that were chasing them, then needed an ambulance for a minor injury and ended up unresponsive with a breathing tube in the E.D.

and then there was the:

 - out with family and suddenly collapsed.  This patient had a massive brain bleed and ended up dying in the emergency room before the end of my shift.  They most likely had a brain aneurysm that ruptured and that was it.

The rest of the patients I had ended up being everything from a cracked skull to facial bruising, and I put the medical student to good use stapling and suturing all the various lacerations.  This, of course, kept me free to move onto ordering the next CT.