February 2012
31 posts
Dear ICU,
If you have a patient who is DNR, and is about to code, please don’t call a code blue.
It creates unneccesarry drama for the family if they’re present and, on top of that, I have to run across the hospital and run into a hospital room full of grieving family members.
It’s awkward.
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It’s all fun and games until someone loses the chart
4 ambulances in 5 minutes makes a very busy ER
And some very sore feet.
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Hospital drama is the worse kind of drama.
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How Doctors Die
ashrubbery:
photo by patrick.ward04.
It’s Not Like the Rest of Us, But It Should Be
read on Zócalo
TSK: The Power of Negative Thinking
Cranquis: Well that strip of painful redness and blisters on your chest and back is shingles, ma'am.
60-something female patient: IT IS? HALLELUJAH!
Cranquis: Uh, ok -- I have to know, what did you ~think~ it was, that you feel shingles is a better option?
Patient: I thought it was breast cancer!
Our Unrealistic Attitudes About Death, Through a... →
I know where this phone call is going. I’m on the hospital wards, and a physician in the emergency room downstairs is talking to me about an elderly patient who needs to be admitted to the hospital. The patient is new to me, but the story is familiar: He has several chronic conditions — heart failure, weak kidneys, anemia, Parkinson’s and mild dementia — all tentatively held in check by a...
18 Patient Identifiers HIPAA Defines as Off Limits... →
dorasnursing:
The Nerdy Nurse blogging about HIPAA.
Things to avoid if you blog about medicine.
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Code Blue
Yesterday I attended my first Code Blue in which we were unable to resuscitate the patient.
This specific patient came into the ER the day before with complaints of hypertension (above usual) and pedal edema. He had ESRF (End stage renal failure) and got dialysis twice a week. The ER physician wanted to admit him but his nephrologist decided he didn’t need to be admitted to the hospital...
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You know you need sleep when:
Physician: Hey, what's the patient's Hemoglobin and Hematocrit?
Me: Well his BUN and Creatinine are normal
Physician: I asked for the H&H
Me: ....
Physician: ...
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Spontaneity
So about a month ago in the ER, on a really really slow day, we get a call from one of the Urgent Care physicians about a patient he was sending to the ER.
Apparently, this older gentleman came into the urgent care clinic complaining of Shortness of breath (SOB). He wasn’t obese but had a history of Hypertension and a random pneumothorax a year ago. (I bet you can see where this is going)....
Psych Symptoms Prevalent in Kids with HIV
missmd2be:
“In a snapshot study of children and adolescents with HIV, about a third met criteria for at least one psychiatric disorder, researchers reported.
But there were only a few associations between psychiatric disorders with such HIV variables as viral load, and a clear picture did not emerge from those that were found, according to Sharon Nachman, MD, of Stony Brook University in Stony...
1 tag
TIME article: "When the Patient is a Googler" →
cranquis:
There’s so much information (as well as misinformation) in medicine — and, yes, a lot of it can be Googled — that one major responsibility of an expert is to know what to ignore.
Great article about an orthopedist’s over-informed patient, and the way that doctors have to adjust their communication styles for “Googlers”.
This is all too true. Google and sites like WebMD, while...
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Let’s add to the list two septic patients, a nasty case of C-diff, a STEMI, and a subdural hematoma
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Things I have seen today include:
- A MVC (car accident) requiring extraction that involved 2 patients.
-another MVC where the driver had a seizure and had a x5 rollover
- a cancer pt randomly going into uncontrolled a-fib with RVR who then would go into SVT
-A spontaneous pneumothorax
Still 5+ hours to go..
Tonight feels like I’m guest starring in an episode or ER or Grey’s Anatomy. This place is going crazy
Sorry for the delay in stories!
I had to work more than I intended to over the weekend due to our increasingly high patient volume.
I think on Thursday the physician and I ended up seeing somewhere in the range of 30 patients in 8 hours. I don’t know if that’s a lot in urban hospitals, but where this hospital is located, that’s a lot, especially when we only have on ER physician after 2200.
So…once I...
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Ran to a code on another floor only to find out a family member “accidentally” pressed the code blue button.
At least I got my exercise.
People ask me "Why do you want to be a vet? You...
the-angry-apple-tree:
Maybe because I actually care about animals and they aren’t systematically destroying the planet like humans are? Besides. 90% of human medicine is keeping people alive when they should have died a long long time ago, I want to help animals. Fuck off.
How to be self righteous 101
I don’t normally pick fights with people, but are you kidding me right now? Sure...
I’ve been asked a few times how this blog isn’t a violation of HIPPA and I am quite happy to answer that to the best of my ability.
I never mention where I work. It would be extremely hard if not impossible to determine where I work solely based on the fact that I live in Texas. There are somewhere around 500 hospitals in Texas. If you can figure out where I work I will give you a...
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Code Stupid
Note: This is not a personal experience of mine but one that I was told by a coworker.
So at least in the hospital I work at, when a Code Blue is called, one of the emergency medicine physicians has to respond to it regardless of whether it is in the ER or not.
For those who don’t know, a code blue is a universal term (at least it should be) used in hospitals when a patient is going...
My computer had a sudden run of vtach and has unfortunately died. Stories will be delayed :(
Stories you should expect in the next week...
A story about a spontaneous pneumothorax
And a story entitled “Code Stupid”
I have a pretty busy work schedule this weekend so I’m not sure when I’ll write them, but I’m sure they’ll be interesting to most of y’all :)
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Thank you to all the new followers (all 100 of you).
Also thank you to the ever secretive Dr. Cranquis for making people aware of this tumblr :)
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Sitting on the saddle of death
Among the many strange things I have seen, this has to be in the top 5.
Several months ago, an seemingly healthy 38 year old male came into the hospital complaining of intermittent bouts of shortness of breath that would only last for a few seconds of so for the past few weeks. He didn’t want to come into the emergency room, but when his wife found out about the shortness of breath, she...
7 tags
Midline shift
So, I used to have this nickname at the ER when I first started working there. I was referred to as “The Black Cloud”, because everytime I came into work, there was some extremely critical patient who was on the verge of death.
So one day I walk into the ER, and as soon as I got near my “office” that is in the middle of the nurse’s station, I see the paramedics bring...
