Monday, August 29, 2011
Sunday, August 28, 2011
Saturday, August 27, 2011
Friday, August 26, 2011
"The 2 mechanisms that cause tissue damage are corrosive burn from the free hydrogen ions and chemical burn from tissue penetration of the fluoride ions.
Fluoride ions penetrate and form insoluble salts with calcium and magnesium. Soluble salts also are formed with other cations but dissociate rapidly. Consequently, fluoride ions release, and further tissue destruction occurs.
Systemic toxicity occurs secondary to depletion of total body stores of calcium and magnesium, resulting in enzymatic and cellular dysfunction, and ultimately in cell death. Majority of deaths are resulting from cardiac arrhythmias that were precipitated by hypocalcaemia and consequent hyperkalemia."
Thursday, August 25, 2011
Wednesday, August 24, 2011
Mrs. H: "No. I married an Englishman, but I am German."
Mrs. H, accepting: "I suppose it would be." She looked into my face and as I smiled, she smiled back and I took the opportunity to slip her hands through the sleeves of a new hospital gown. At least now she was dressed.
Twenty minutes after I was supposed to leave, I mentioned how late it was and asked whether she was tired.
S: "Not at all, Mrs. H. Sleep well!"
Tuesday, August 23, 2011
Monday, August 22, 2011
Sunday, August 21, 2011
Saturday, August 20, 2011
Imagine my surprise when I walked in, turned the lights on, and jumped at seeing an older man sleeping in one of the soft office chairs. He was balding and wore the khaki pants and polo shirt that many researchers down the hall would wear. I did not want to wake him, so I trudged to another room with all my belongings. My music students were arriving and we made use of another room until there was a lull in activity. I took a peek in the conference room once more- the man was gone. Hooray! I put my instrument and purse in the room and went outside to greet more students.
Friday, August 19, 2011
Wednesday, August 17, 2011
Abscesses are like the perfect emergency. They are an emergency because not treating them could cause them to burst into the bloodstream, a direct point access to the bloodstream by the pathogen, which could be hard to treat, like MRSA. They also hurt- a lot. All the pressure from the pus build-up can really dig at a person. Once you lance them, the pain, pressure, danger is immediately gone. The patient usually can go home with an antibiotic if there are no complications or cellulitis. Abscesses are a quick trip to the emergency room and something can be physically done to relieve the patient. Perfect.
Tuesday, August 16, 2011
"Sir, can you walk?"
"Can you walk well?"
Monday, August 15, 2011
"Something called stress-induced cardiomyopathy."
Mr. M&M: "All I want is my wallet. That's why I'm here. I want my wallet."
Mr. M&M: "Well I'm a patient."
Mr. M&M: "My legs and back hurt real bad. I can't walk. Can you admit me as a patient?"
Mr. M&M: "What's your name?"
I turned around and suddenly heard a scuffle. Mr. M&M was trying to wheel himself outside to smoke a cigarette. Security caught up to him and made him get up and get out. We thought it was the last we'd see of him....
Nurse: "Get off the stretcher. We're not dealing with you again. You were discharged this morning, you came back a few hours later, and now you called an ambulance to come here again. Please leave."
Nurse: "Why are you saying that now? Do you really want to hurt other people?"
Mr. M&M: "Saying that will get me back in the psych unit, right?"
Nurse: "Uh, that will get you arrested, actually."
S: "Well, when you say things like that and you don't mean it, don't you think that comes off a little... manipulative?"
Mr. M&M: "Well I don't mean to be manipulative or anything..."
Sunday, August 14, 2011
Saturday, August 13, 2011
Thursday, August 11, 2011
Tuesday, August 9, 2011
Saturday, August 6, 2011
What's the most dangerous vegetable to have on a boat?
Friday, August 5, 2011
I had some very ill patients today that should not have been in the general emergency section I was working in.
"Yes, thank you, thank you."
"Can I see your arm?"
Thursday, August 4, 2011
Mr. Slick began his ER hallway drunk-tank adventure as an explorer. He sailed through the halls, through uncharted wildernesses of unused stretchers and linen closets, stopping man and beast alike to chat and build local street cred. He sensed the triage nurses were inattentive and slow and he knew the system like the back of his hand. Eventually, he was caught by the native security guards and escorted back to his bed without being tied down. He tried to talk me out of his involuntary stay on his stretcher, but it was to no avail. Grumbling, he covered himself with a sheet and passed out for a few hours. His BAC was .380.
Wednesday, August 3, 2011
Our ER was full to capacity again last night and both of them were put in the same back hallway to await sobriety. The stage was set for disaster because Ms. Regular is spoiled and Mr. Mumble-de-Gook does not ever shut up. I have never understood a word he said except that time I figured out, he was saying "hungry" and gave him the sandwich.