medic25 Posted March 2, 2015 Share Posted March 2, 2015 Another thing I'll tell parents to do (and do at home) is to designate one person in the house as the "medicator". This way they aren't accidentally doubling up (e.g. mom gives APAP at midnight while dad sleeps, dad gets up at 1am with crying baby and doesn't realize the last dose was an hour ago, gives another dose). Link to comment Share on other sites More sharing options...
taotaox1 Posted March 2, 2015 Share Posted March 2, 2015 Mine is Tylenol pm for people who want to sleep, who have no pain. The people at tylenol should be ashamed for making the stuff..... Link to comment Share on other sites More sharing options...
rocketpropelled Posted March 2, 2015 Share Posted March 2, 2015 Because....Benadryl. Link to comment Share on other sites More sharing options...
sk732 Posted March 3, 2015 Share Posted March 3, 2015 Being Canadian and therefore metric, I hate when people come in saying their temp was 100 and whatever Deg F when this country has been using Deg C since 1978...and the thermometers are calibrated to come up Deg C ahead of Deg F. My issue is I don't like drama - and having a temp over 100 is much more dramatic than 37 (not even fever) or 38 (just barely fever if I'm up for playing their silly game). These same people will discuss ambient temperature with me in Centigrade when we're talking about the weather. And as noted, the antibiotic seekers will really keep reiterating their/their kid's temp like I didn't hear anything. One thing about vitals, especially if you're worried about pneumosepsis, don't forget about relative bradycardia with some atypicals. Just had a patient in the ER 2 days ago with that and a rather nice lobar pneumonia - temp was 39 Deg C (102.2 F) with a HR in the 60's and not beta blocked. SK Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 3, 2015 Moderator Share Posted March 3, 2015 as a father of a 2 year old I can attest to the confusion with when to give meds I figured out with the first illness write out APAP and IBU on a sheet write the dose next to it - and the dosing interval - ie 5ml every 6 hours Then just extend a quick table under it - and whom ever gives meds just writes down when they were given - makes it easy (and not having this it IMPOSSIBLE to remember when you have a sick crying kid at 4am for the second night in a row....) If I were still in ER or PCP I would have a blank table written up that I could fill in the ml of meds and just hand it to the patients parents... Link to comment Share on other sites More sharing options...
Guest Paula Posted March 3, 2015 Share Posted March 3, 2015 My "fever" story: Happened yesterday. 74 y/o c/o fever and "fatigue". Normal temp is 97 and has 2 day hx of 99 fever, up to "maybe 100 F". Afrebrile at presentation at 98.9. SOB a "bit more than usual" and had 3 episodes of hemoptysis, but also had sinus drainage with right side epistaxis. HX of AFib, on coumadin. Long story short, I asked lots of questions, ordered a CXR and he also went to the coumadin clinic for recheck. PT/INR at 5.8 and CXR with an 11cm mass in left lower lobe. Don't discount a fever story and let it trip you up and put blinders on, thinking it's just blood from the epistaxis and that he is just coughing up blood in the posterior pharynx. (At least with adults with comorbidities). It was my first day seeing patients at my new job. Whew! What a day! While doing the medical interview he said to me " you have asked me more questions that what the doctor does, they just come in ask me how I'm doing and I'm out the door". It pays to be anal. Link to comment Share on other sites More sharing options...
Guest Paula Posted March 3, 2015 Share Posted March 3, 2015 ^^^Actually it really doesn't pay when you are on wRVUs and you take time with the pt, but, oh well. Link to comment Share on other sites More sharing options...
sk732 Posted March 3, 2015 Share Posted March 3, 2015 I just tell people I'm paid by the hour, not the patient...though now I'm in ER vice Office, I do try to speed things up a bit, since our dept tends to fill at the blink of an eye these days. SK Link to comment Share on other sites More sharing options...
Febrifuge Posted March 4, 2015 Share Posted March 4, 2015 Age 74 makes me pay attention to "fever" of 99 anyway, but it's a point well-taken. I too am paid by the hour, not by the patient, but I feel like people would get salty with me if I said it out loud. I do know that when I see a kiddo who has had two different oral antibiotics for AOM in the past 3 weeks, but has also just started swimming lessons twice a week and actually has otitis externa... well, somebody was in a hurry, most likely. It's a pleasure and a gift to not have to think in RVU's. Link to comment Share on other sites More sharing options...
Acebecker Posted March 8, 2015 Author Share Posted March 8, 2015 I think it's important to remember that in the geriatric population, fever response is blunted. Agree with the above; pay attention to temps at 99 or more. But the situation I described earlier was an otherwise healthy 45 year old. I'd also like to add that if y'all want to turn this into a vent thread that's fine with me. That's pretty much why I started it. Link to comment Share on other sites More sharing options...
CByersPAC Posted March 10, 2015 Share Posted March 10, 2015 Agree with the "fever" pet peeve. I generally smile and say "well, the normal human body temperature is a moving target," then move on. I think people feel like having a fever legitimizes their illness. I don't think it's a plea for antibiotics. I think it's a plea for being taken seriously as ill. I try to validate their other symptoms and their general feeling cruddy by acknowledging their discomfort, or saying something like "you don't have to have a fever to feel awful." Link to comment Share on other sites More sharing options...
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