Two people tied for the "Holy Crap" award (so named because they're the people that make you go, "holy crap" when you're done triaging them. And they were at opposite ends of the Holy Crap scale.
At one end of the spectrum was a guy who got drunk last night and fell, injuring his thumb. Eh, whatever, right? When he held out his hand for me to inspect it, HOLY CRAP! It was bent backwards at the distal knuckle. The tip was bluish with no capillary refill and . . . What's that? Oh, the bone from his knuckle protruding through the skin--on the ventral side. Lotsa meat hanging offa there. Not a lot of blood, and when I asked the guy if it hurt, he was more concerned about his scraped knee.
At the other end of the spectrum was the gal who sat down in triage with a chief complaint of . . . Sunburn. Her legs were sunburned. No fever, no blisters, no sun poisoning. Rated the pain 10/10. Refused motrin, just wanted some "cream or something." HOLY CRAP! Seriously. "I can't sleep! I can't get comfortable!" Know why? Cause you have a sunburn. You know, at the drugstore they have all sorts of creams and lotions for sunburn. Even ones with aloe and lidocaine! There is a 24-hour pharmacy about four blocks from the hospital--if you could make it here, you could make it there.
Seriously.
9 comments:
My favorite eye-roll-at-chief complaint-which-came-to-a-screeching-halt was a dude I called in from the waiting room for a "splinter". I didn't try to hide the disdain in my voice when I said, "so, a splinter brought you in tonight?". He calmly says, "yeah" while he rolls up his plaid flannel shirt to reveal a 1 inch diameter 'sliver' from wrist to elbow just under the skin. "Holy Crap!" I said as plastics whisked him off. I think I saw the triage nurse giggling at me when she saw my eyes bug out of my head.
I had one in april on my hand surgery rotation for residency that was a "holy crap"!
this was a 70 yo male who was using his old lawnmower with a pull string, and he got his finger wrapped around it, and the string degloved the entire middle finger on one of his hands....he sat at home 3 days until his hand became swollen, and he then came in, and we promptly amputated his hand..
he said he put alcohol on it to kill the little buggers that could be there, but his girlfriend made him come in.
Regarding the patient with the sunburn -- remind me again why you have to even see these patients. Can't you just give them a medical screening exam and send them on their way?
I must confess. I went to the ED for a splinter once. Only because I could not get the splinters out, it was a weekend, and my hand was becoming very swollen. They admitted me for a couple of days with IV PCN.
The doctor insisted that the splinters were out, so he was surprised that a month later 2 splinters over an inch long came out of my thumb.
I am surprised that these are holy crap stories with no mention of bowel movements. :-)
ndenunz: because no one has defined precisely WHAT a medical screening exam is. Is it by a nurse? an MD? a PA?
So we have to triage them, and if they feel like waiting six hours (from 11pm to 5 am) out in the waiting room to be seen (and screened) by a doc, so be it!
I did 6 and thought I had it bad! LOL. Course we are just an Urgent Scare, but we see around 120 a day. from 8a-10 pm. Record is 160 and that's with just two docs and 3 nurses and a couple of techs. Not the acuity of the ER though, although we send about 5 or 6out via EMS a shift!
Good job on the Holy Craps- LOL.
J
Friday night was one "holy crap" after another, a good ole "Holycrapapalooza!"
Love the Marshall Stacks. In 1977 I put my Les Paul (Ibazez, I aint rockafella) on top, tripped on the cord and cried when it crashed to the ground. I've still got the Ibanez but had to sell the stacks.
Michael--
For the picture I used a mini-stack--I think in real life it's about three feet high. I actually have one in storage-it's red and very cute, and I used to use it as a practice amp, and for home recording because it has a direct out.
My main rock amp is an ancient (1976) Marshall half-stack: hundred watt head with a 4x12 cabinet with Celestion greenbacks in it. Sounds killer.
"Sounds killer."
I'll bet!
I'm down to a Crate mini with built in effects. The only one that sounds any good is the flanger. I've still got a few pedals from back in the day, delay, chorus and a weird Swedish distortion/overdrive to make things interesting.
I found your site a while ago and listened to your band doing an MC 5cover, I think. I loved your sound but forgot to post a comment. Time takes its toll on the old noggin!
Post a Comment