Sunday, January 27, 2013

things are not always as they seem

My hospital specializes in a lot of shit.  Cardiology, neurology, orthopedics, etc etc etc.  Therefore, as an ER, we get a lot of medically complicated, seriously ill people in addition to the usual ER baloney.
Some days it feels like this is all we get.

So there I am minding my own business at the desk. I'm up for the next patient. One is coming by ambulance. I click on the computer to see whats coming in.  45 year near syncope. Hmmm.  Somebody vaso vageled?  Tey are dehydrated?  Whatever, I can handle it. The're young.  How bad can it be?

Of course, there is way more to the story. Turns out this woman has cardiomyopathy, diagnosed 1 month ago after having increased shortness of breath.  They were found to be in congestive heart failure. Their ejection fraction is 20%.  Had probably been in atrial fibrillation for a couple of years without treatment.  They must have had some episodes of v tach or very rapid heartbeat  because now they have an external defibrillator.

So the simple syncope turns into a big deal.  This is typical.  What looks to be simple is really way more complicated.  Often times when we get a call about an ambulance coming in from medic control, the information is a couple of sentences, failing to mention all of this other shit.  Like they are a quadriplegic or post heart transplant or mentally disabled from a group home.

Sometimes I think, whatever happened to sprains and lacerations and appys and what you would normally think comes into the ER?  They seem to be a thing of the past, replaced by by the MI who is on dialysis, a crack head and of course has no veins....


Nurse Lily said...

Sometimes the constant baloney can really mess with you. It gets to where that's the norm so when you see a 45 yo near syncope, my first thought would have been "drama not trauma", lol. That can really bite you in the ass. But I love you for saying that 45 is "young"...made my day! ;)

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