Hillbillie Chick

Friday, May 05, 2006

ER Stuff

When I first started this blog, it was originally for me to vent about stuff going on at work (the ER). But I got carried away with family and wedding stuff that I haven't really posted any about work. And more than a few of you have said MORE GORE STORIES! So I thought I would try and dredge up a few.

Deceased Human Couch

Have any of you heard about the joke/urban legend called the human couch. About an obese patient in the hospital, and once they started undressing the patient, found all sorts of things (like TV remote) and stuff in their skin folds? Well, I had a similar story that is not urban legend but true (although sad). A 26 year old male brought in by EMS (ambulance). Found in his car slumped over, unresponsive. When they got to him he was not breathing nor was his heart beating. So they started CPR and all that. Had some trouble getting him out of his car and onto the gurney as he weighed, oh about 400+ pounds. While they were getting him out and onto table, started finding all sorts of drugs and drug paraphenalia in his skin folds. Brought him into my ER where we never did revive him and pronounced him dead. So the lovely task goes to ME to tell family that their 26 year old son was dead. This was their baby. And of course mom wants to know why did he die. I had to tell her that drugs were found with her son. She told me that she was sure he wasn't taking any of them. I did NOT correct her on that. That was probably one of the worst times I had to tell a family about their loved one. It is always hard, but when it is an 80-90 year old person, they (the family) kinda expect it. But you do not expect it when it is your 26 your old baby!!

Breaking bones for fun and profit

Speaking of 90 year old family members...Last month I started my shift as normal. I was seeing patients: colds, coughs and all that. I knew that there was a patient in one of the big trauma rooms - a 93 year old woman in respiratory distress, but that they had already been there a few hours, had already been worked up by the other doc, already intubated (tube in their mouth and down their throat connecting them to a machine to help them breathe), and they had an ICU bed already and was just waiting to go upstairs. When of course all of a sudden one of the family members comes out and says grandma is throwing up. We go in and sure enough she is. She is sedated because of the tube in her mouth but the vomit is coming out of her mouth. We suction it, but then see that her pulse is dropping and her blood pressure is dropping (she is already on some IV medication to try and get her blood pressure up). I start CPR while my attending talks to the family to see what their wishes are (do we keep coding her with CPR and drugs and shocking her heart OR let her die peacefully). Now one of the risks of CPR is that you can break ribs when you are doing it, especially in old frail people. But I have never experienced that. Yet there is always a first time isn't there? So while I am doing CPR on this poor 93 year old woman who should be allowed to go home instead of being forced onto a vent and drips and such...but that is another story for when I get on my soapbox...anyway...while I am doing CPR, I feel and hear a CRACK and know immediately that it is a rib I have just broken. My insides turn to mush as it is one of the ICKIEST feelings I have ever felt. And it happens two more times...CRACK....CRACK... so all in all I broke 3 ribs on this lady before the family finally had the gumption to let her go. I will never forget that feeling/sound.

Liar, liar, pants on fire

This isn't so much a story as an explantion of why doctors sometimes do tests that you may think are unnecessary. Especially if you feel you have told your doctor why you don't need them. Every doctor has hundreds of these stories, and I have many as well, but I will tell just one. Lady comes in complaining of nausea and abdominal pain. She is about 41. And of course during my interview ask the regular female questions, where was your last period, any chance you could be pregnant, blah, blah, blah. And of course the answer is ABSOLUTELY NOT, there is NO chance I could be pregnant. Plus I have had my periods regularly for the past several months, I have NOT missed one period. But doctors still check everything so I do a pregnancy test and lo and behold it is POSITIVE. We do an ultrasound and she is 19 WEEKS PREGNANT. Not a month or two, but 19 WEEKS. And though I have never had this, we docs always hear the stories of women showing up in the ER with abdominal pain or rectal/hemorrhoid pressure or whatever, and when the doctor looks, there is a head crowning (birth about to happen). Plus I cannot tell you the number of women that come in and tell me that there is NO chance they could be pregnant. I ask "Are you sexually active?" They say YES. I ask "What birth control do you use?" They say NONE. OKAY PEOPLE, IF YOU ARE OUT DOIN' IT, AND ARE NOT USING PROTECTION, THEN THE ANSWER TO MY QUESTION ABOUT WHETHER OR NOT THERE IS A CHANCE YOU COULD BE PREGNANT IS YES!!!!!! idiots.

So while I do not believe people are out to purposely lie to me, I still check everything!!

I will try and remember some more good stories and post them here...

posted by Holly at 12:55 AM | |

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Holly, Rural Appalachia, United States

Just finished my emergency medicine residency

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