theme days
Sometimes, shifts in the Emergency Department end up having a theme. Such as, "Drunk Tank Day" (usually a Friday or Saturday overnight shift), or "Chest Pain Day", or "Vaginal Bleeding Day" (one shift, after 5 pelvic exams, I remember grumbling to anyone who would listen, "if I wanted to do pelvic exams all day, I would have become a gynecologist").
On Thursday, I woke up with a queasy stomach. Not terrible, but enough so that I had to keep swallowing to make sure things stayed down where they were supposed to. I think it was probably from the (slightly old) smoked salmon I ate the night before. In any case, I rolled into work, thinking I'd be too busy soon enough to even notice the queasiness.
Oh no. If I would only be so lucky.
Our patient tracker system gives us basic information on each patient, such as name, age, and chief complaint (the reason why they're here to be seen). My first patient of the day was a woman in her 30's with fever. Okay, I can handle this. I walk in:
"doc, I have a fever and my whole body hurts and I'm sick to my stomach and it burns when I pee...."
Then she proceeds to vomit as we're getting her worked up for her kidney infection. Great. I'm right there with you, ma'am.
Second patient was a 3 year old who comes in with vomiting. Okay, I admit, this one I knew walking in. But, it didn't mean that he had to turn and puke in my general direction 2 minutes after I walked in the door. Yum. Thank god it wasn't projectile.
Third patient came in as a "Code Grey", which means a non-life threatening emergency in medspeak. Usually somebody falling or fainting. Pretty harmless. Well, this was a pregnant patient who had passed out and fallen down...after, you guessed it, three days of nausea and vomiting.
Patient four was a little old lady with belly pain. Usually these are pretty harmless...except this little old lady had an ongoing problem with intractable vomiting, had a gastrostomy (feeding) tube placed to help her eat, but had vomited so much overnight that her stomach tube (which, by nature of being called a stomach tube, should be in the stomach) had become malpositioned like halfway down into her small bowel. We got a CT scan of her belly to make sure nothing was perforated. Her poor small bowel was all scrunched up along the feeding tube, kind of like how leg warmers looked like on fashionable young ladies back in the 80's.
At this point I think I just resigned myself to the fact that it was, in fact, going to be a "Nauseated Vomiting Patient" day.
And of course, everybody loves hanging on to their vomit to show the doctor: "doc, take a look at this, this is what I've been throwing up!" I mean, people will come in with little plastic baggies of nastiness so their doctor will know exactly what is wrong with them. Because it's not enough that you say "I was rolfing up blood clots" or "the puke was yellow and watery and tasted sour". Everybody knows doctors won't believe you unless you have physical evidence in hand.
Um, thanks so much.
On Thursday, I woke up with a queasy stomach. Not terrible, but enough so that I had to keep swallowing to make sure things stayed down where they were supposed to. I think it was probably from the (slightly old) smoked salmon I ate the night before. In any case, I rolled into work, thinking I'd be too busy soon enough to even notice the queasiness.
Oh no. If I would only be so lucky.
Our patient tracker system gives us basic information on each patient, such as name, age, and chief complaint (the reason why they're here to be seen). My first patient of the day was a woman in her 30's with fever. Okay, I can handle this. I walk in:
"doc, I have a fever and my whole body hurts and I'm sick to my stomach and it burns when I pee...."
Then she proceeds to vomit as we're getting her worked up for her kidney infection. Great. I'm right there with you, ma'am.
Second patient was a 3 year old who comes in with vomiting. Okay, I admit, this one I knew walking in. But, it didn't mean that he had to turn and puke in my general direction 2 minutes after I walked in the door. Yum. Thank god it wasn't projectile.
Third patient came in as a "Code Grey", which means a non-life threatening emergency in medspeak. Usually somebody falling or fainting. Pretty harmless. Well, this was a pregnant patient who had passed out and fallen down...after, you guessed it, three days of nausea and vomiting.
Patient four was a little old lady with belly pain. Usually these are pretty harmless...except this little old lady had an ongoing problem with intractable vomiting, had a gastrostomy (feeding) tube placed to help her eat, but had vomited so much overnight that her stomach tube (which, by nature of being called a stomach tube, should be in the stomach) had become malpositioned like halfway down into her small bowel. We got a CT scan of her belly to make sure nothing was perforated. Her poor small bowel was all scrunched up along the feeding tube, kind of like how leg warmers looked like on fashionable young ladies back in the 80's.
At this point I think I just resigned myself to the fact that it was, in fact, going to be a "Nauseated Vomiting Patient" day.
And of course, everybody loves hanging on to their vomit to show the doctor: "doc, take a look at this, this is what I've been throwing up!" I mean, people will come in with little plastic baggies of nastiness so their doctor will know exactly what is wrong with them. Because it's not enough that you say "I was rolfing up blood clots" or "the puke was yellow and watery and tasted sour". Everybody knows doctors won't believe you unless you have physical evidence in hand.
Um, thanks so much.
posted by yvonne at 9:38 a.m.
2 Comments:
And none of this triggered your own transition from nausea to vomitting? Impressive
- michelmo
it almost did, but I basically ended up trying to avoid being in these patients' rooms as much as possible...at least until they all got antiemetics in them! :)
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