At 12 noon, those of our rooms that were filled looked like this:
Rm 2: ETOH (BAL 390)
Rm 3: Seizure (from ETOH withdrawal, from jail)
Rm 4: Seizure (ETOH withdrawal, not from jail)
Rm 10: Depression (with suicidal ideation)
Rm 11: Depression (without suicidal ideation)
Rm 12: Depression (from jail; made slashing with finger across throat, and mimed a gun pointed at head. Suicidal ideation
Rm 13: Abdominal pain (17th visit this year for same)
Rm 15: Abdominal pain (2oth visit this year, 3rd in last week. Known for narcotic seeking behavior)
Rm 16: ETOH abuse, depression, and thinks he might have a seizure. Oh, and chronic back pain.
Rm 17: Intoxicated man found sitting on the curb in downtown area. He quite charmingly pisses on the floor. Lovely.
At 12:20 PM we get a patch for "37 year old female. Hearing voices"
At 12:50 PM, we get what appears to be our first actual emergency patient of the day, a 52 year old female with hypertension and severe headache. This turns out to be a frequent flier who routinely doesn't take her antihypertensives, cranks her BP up to a nice healthy 220/120 and complains of intractable headache in order to get Dilaudid and hopefully admitted for more Dilaudid. Or at least she did until admin. devised a treatment plan that included admission only if her BP doesn't come down. I love lopressor.
At 1:30PM we get advanced notification that we are getting a code: 62 year old male, witnessed cardiac arrest after complaining of shortness of breath. Bystander CPR initiated immediately by co-worker who also happens to be an EMT. This sounds as promising as such things do when the right things happen in a tmely manner.
At 1:42 we get the patch: Pt in PEA (pulseless electrical activity), and IV access is two IO's (intraosseous).
By 2:10 PM we have done all we can do. The patient does not survive.
The worst thing is that in order to see their loved one, the poor man's family has to run the gauntlet of alcoholic assholes yelling for food, cigarettes, their rights, their lawyers, and cab vouchers.
Sometimes there are just no good things to say. So I won't.