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....