Sunday, September 14, 2008

No Words

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.


Karin, RN said...

Wow, that sounds like a mentally draining day.

mojitogirl said...

Sounds like heaven to me! I'm jealous because I'm bored out of my skull!

I need a shift in the ER to bring everything back into perspective!

Anonymous said...

So the health care system is "broken" according to popular sentiment. I think what is broken is our thinking.
We should have county homes or farms to put all those drug seeking folks. That would free up space in the ED's for REAL emergencies.
Oh thats right we can't "put" people in county homes or on farms....thats sooooo degrading.
I don't seemed to work "back then". Those folks had things to occupy their time; like milking cows, tending crops,etc.....


Kym said...

ETOH and other drug abusers need to be hooked up to ventilators and paralysed (but not sedated) for 48 hours, maybe a special ward is required for this but you would only need one person to keep an eye on them. Just think, rows of quiet ED patients causing no problems at all. I bet that would cut down on return visits.