Rockin weekend

[EMEDPA]

over the last several days have seen the following:

epiglotitis in a 40 yr old freebasing crack. fiberoptic nasal intubation done by ent. used cpap as a bridge until they arrived.

65 yr old with acute etoh withdrawl/borderline DTs: altered, found running naked down the freeway in the snow by police. ativan 14 mg IV over 2 hrs.

nonstemi 87 yr old

gi bleed 96 yr old, H+H 8/24

67 yr old rapid afib/chf trainwreck. failed rate control with cardizem, admitted icu on digoxin

uroseptic 82 yr old bounceback from icu d/c a few days earlier...sent home on abx he had a resistance to, got worse again(not surprising),

75 yr old pelvic fx slipped on ice

60 yr old hepatic encephalopathy, ammonia = 150

 

my partners also flew 2 pts to regional referral ctrs:

2 yr old with (mrsa) bacterial tracheitis and impending resp. failure

30 yr old with c-spine fx and paralysis

[whoRyou]

:-O WOW what a wild ride EMEDPA

[skyblu]

I had a rockin' weekend too, although not quite as exciting.

 

47 yo alcoholic male with esophageal varices with 4.5 liters (measured) of hematemesis. Awake and alert but with BP of 70/palp, HR 165. Required 6 units of blood in the ED, intubating with glidescope (blood EVERYWHERE!), emergency endoscopy where they ligated his varices.

 

A code where EMS had initiated CPR on a guy with rigor mortis. Who weighed 430 lbs. The wife didn't want to upset her grown kids so when she called them, she told them to come to the ED because "Dad took a fall." It was up to me to break the news to each kid as they arrived. Lather, rinse, repeat x 4 kids.

 

A septic pneumonia patient who was only 48 and with no other comorbidities. Her infiltrate took up 2/3 of the left lung and rads had me scan it bc he couldn't believe it was all PNA (it was). Her vitals on arrival were BP 89/50, HR 154, RR 34, temp 104.2 (!!), O2 sat 86% on room air. I later found out from ID she has Legionella.

 

A 27 yo female psych who had barricaded herself in her apartment with no heat (28 degree day), arrived awake, manic, floridly psychotic and buck naked, ran around the department yelling "Don't touch me, I'm off my NuvaRing!" and doing ballet pirouettes. Naked. Security eventually caught up with her so I could 5&2 her.

 

Dislocated PIP on the ring finger with massive edema and a very stuck wedding ring. None of my ring removal methods worked so I had to call the fire department to do it. Then I put the finger back in place. The guy (crotchety old guy) kept telling me "it's a man's job, call a man to do it", but immediately stopped whining when I had reduced his dislocation in 2 seconds flat and he didn't feel a thing.

[EMEDPA]

sounds like a busy weekend for you as well.

bleeding varicies is not one of my favorite complaints...have seen several folks bleed out with these...when I was a medic we had a lady with varices projectile vomiting blood....had a 300 lb guy a few yrs ago with hep c in full arrest (PEA) from a variceal bleed.

[skyblu]

Yeah. I've never seen someone with this much bleeding who was still alive, let alone awake and alert. It was...messy.

[ehfrost]

I am a first year student. Reading this stuff is so much fun. Thanks for sharing.

[PAruby]

I hope to have a job like that someday :) 

[skyblu]

Oh, you guys. EM can be so much fun but also so, so draining. I love excitement (duh, that's why I do this crazy job for a living!), but some days, I admit I pray for an urgent care assignment.