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10 ways to tell that you don't have an emergency

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^^^^fricken hilarious.^^^^

 

Had a guy come in once for a scratch. Literally a scratch on his arm.

 

I said "that's a scratch, you've never had a scratch before?"

 

He said "yeah I have, I just wanted to get it checked out"

 

Scientist say that hydrogen is the most plentiful matter in the universe.

 

Frank Zappa disagrees. "It's not hydrogen that's the most plentiful substance, it's stupidity"

 

Sometimes I wonder.

 

 

Its one thing to come in for a scratch. It's another to demand Vicodin for a scratch, which is what I had someone do a couple years ago.

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Houston only boards if there is a neck pain compliant or significant mechanism (simple MVC is NOT sufficient mechanism)

 

 

OP: Im allergic to toradol, ultram, ibuprofen and acetaminophen. I can only take norco or lortab.

 

Really???

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I twisted my ankle 2 weeks ago, and have been walking, and even running on it, but it still hurts.

 

I'm going to one-up you on this one...

 

Patient on my fast track shift tonight. Same as you wrote, but trade the 2 weeks for SIX MONTHS.

 

It's feeling pretty much better. But, I just wanted to make sure nothing was broken, you know.

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I'm an ER newbie but I've already had a few good ones including... "no complaint: needs a work note" "my hands feel hot and my feet feel cold" and a 93 y/o female with dementia who was brought in for a psych eval after she yelled at her roommate at the nursing home. when i asked her what happened she told me my hair looked nice for the dance, the year was 1957, the president was eisenhower, and she was at the library. I'm sure the social worker enjoyed doing that assessment...

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I'm an ER newbie but I've already had a few good ones including... "no complaint: needs a work note" "my hands feel hot and my feet feel cold" and a 93 y/o female with dementia who was brought in for a psych eval after she yelled at her roommate at the nursing home. when i asked her what happened she told me my hair looked nice for the dance, the year was 1957, the president was eisenhower, and she was at the library. I'm sure the social worker enjoyed doing that assessment...

 

off topic of emergencies - one of my little old nursing home ladies had a UTI so her dementia was a little worse than usual. At the time I went to examine her, she was in her own little world. She used to be a pretty good horse rider/jumper at one time. So, when I got to see her, she was doing a cross country course and every time I would try and examine her, she would hit me with her imaginary whip to keep me away from her horse. After awhile, I left the room and the other PA I was working with asked me what I did for her. I told him with a smile -"I told her to keep your head up, look over the jump, keep your heels down and sit up tall approaching the fence, breathe -and have a good time". Some days, I think these dementia patients have a pretty good day living in their own world. :)

 

Back to the topic at hand - chief complaint yesterday: " I feel fine, but the right half of my body is smaller than the left half of my body".

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"i have chest pain and i'm afraid i'm having a heart attack" - maam, i need to admit you. "can i drive my 80 year old mother home?" maam, is your mother in the lobby? "no, she's out in the car with the dog."

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All true stories:

 

1.

Young female pt: "I am concerned because I am bleeding from my vagina, I only had one tampon and I soaked it so have been using paper towels and keep going through them."

Me: "Okay, and when was your LMP?"

Young female pt: "I'm not sure... *re-ask her and she goes through her iPhone calender* Oh it was one month ago."

Me: "So you are supposed to start your period today.  Does that sound right?"

Young female pt: "Right.  Do you think that's what this is?"

 

2.

When your chief complaint is "need suboxone" 

 

3.

Took two pregnancy tests at home (LMP was 2 months ago).  Both tests were positive, but needed to be sure so arrived via EMS.

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If you have three or more unrelated complaints. My level of alarm is inversely proportional to the number of unrelated complaints (medical. Trauma is different.) If in the middle of your chest pain complaint you also tell me about your toenail fungus, your ankle sprain from a month ago, and the non-dermatomal paresthesia from a year ago, and also could I please check a pregnancy test so you don't have to shell out the cash at CVS, I'm less concerned that you're dying of a tension pneumo. Not saying you can't be, but it's less likely.

 

As far as chronicity of complaints go, I have a mental tally, and recently a guy I saw in fast track blew my whole record out of the water.

 

40 y.o. healthy Hispanic guy presents with rash on both thumbs. Pruritic, not painful, no other symptoms. On exam, he has a mild linear vesicular rash, no cellulitis. He's a landscaper. Non painful rash, itchy, linear but non dermatomal, bilateral, I'm thinking poison ivy rather than zoster (I was thinking he was holding a machine with both hands, thumbs over handle and fibers under, so if he brushed against poison ivy the distribution could make sense.)

 

Me: "How many days have you had this rash for?"

Pt: "96"

Me: "96 DAYS???" (Rethinking my diagnosis here)

PT: "Nooooo! Since 1996. Right before I came to this country. I moved here right after the skin biopsy."

Me: "You had a skin biopsy? For this same rash?"

Pt: "Yes, and then they sent me to the specialist in the big city in my country."

Me: "So, you've had a minor rash for SEVENTEEN YEARS, which has been evaluated by PCP, BIOPSIED, diagnosed by a prominent dermatologist at a teaching hospital in your country, and you want me to do...what?"

Pt: "Just want to make sure that's what it is. The cream they prescribe clears it up but I don't want to be on it forever, and whenever I stop using it, it comes back."

Me: "....."

Me (in my own head): "Dude, I'm not that smart. If specialists and pathologists who saw your cells under a microscope couldn't fix you, I certainly can't fix you in my 10 minute encounter. Also, the ambulance ride might have been a tad unnecessary, and oh, yes, get the F*CK out of my ER!"

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All true stories:

 

1.

Young female pt: "I am concerned because I am bleeding from my vagina, I only had one tampon and I soaked it so have been using paper towels and keep going through them."

Me: "Okay, and when was your LMP?"

Young female pt: "I'm not sure... *re-ask her and she goes through her iPhone calender* Oh it was one month ago."

Me: "So you are supposed to start your period today. Does that sound right?"

Young female pt: "Right. Do you think that's what this is?"

 

2.

When your chief complaint is "need suboxone"

 

3.

Took two pregnancy tests at home (LMP was 2 months ago). Both tests were positive, but needed to be sure so arrived via EMS.

I just had patient #1 last month.

 

"Last LMP was 29 days ago, and now you're having vaginal bleeding. I think it's your period. "

 

"Can't be my period. It usually comes every month, not every 29 days. "

 

But yes, of course. The emergent medical mystery of the 29-day menstrual cycle. Call 911! Wake up OB! Get them out of their breech delivery of premature quintuplets to come see my...menstruating patient.

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