As my thirteen year old daughter would put it, “it bites” being stuck working on Christmas Eve in the Emergency Department. Considering how busy we normally are on a typical work day, the fact that I am able to sit here with the nurses at the computer typing this entry I find thoroughly amazing. Since 2:00 pm today, my staff and I have been keeping a tally of what pathology has shown up so far. The tally is as follows:
1 ) Varicose vein that bleed and stopped bleeding before arrival. Bandaid applied
2 )Elderly lady. Syncope in the closet. Etiology unclear. Admitted
3 ) The diabetic husband of the elderly lady who fell into the closet (see #2 above) felt his blood sugar was low while trying to pick his wife up out of the closet. Sandwhich provided. Discharged
4 ) A nonbleeding, nonthrombosed hemorrhoid. Tucks Medicated pads suggested. Discharged
5 ) A chronic alcoholic who was brought in because feeling short of breath for days. Medics described new onset afib. Turned out to be an MI who had already “Qed” out inferiorly. Transfered to facilitiy with cath lab.
6 ) Cardiac Arrest in a cardiac transplant patient. (Horrible! Trying to be nice, we shut off all the Christmas music until family left)
7 ) toothache
8 ) Back sprain after a motor vehicle accident
9 ) A scrotal bleed (Don’t ask. Really. Just don’t)
10) Intoxicated alcoholic
11) A panic attack
12) A violent patient with dementia arguing with my 5 foot ED colleague. Demented patient won! (Staff taking bets at nursing station whether five foot tall doctor would win. Not so much. )
13) An ankle sprain.
14) Another toothache.
15) Another minor MVA
16) “I’m out of town and I am out of my oxycodone, percocet 15, ambien, and lorazepam” Discharged unhappy
17) Packing removed from a recent I&D of an abscess
18) STD check (really? On Christmas Eve? Yep . You have one! Discharged. Really. Pun intended. )
19 -22) Assorted lacerations.
23) Knee sprain from three days at work. ( Just ask for the work note! You told us you were do in and we saw you walk into the ER without a problem. )
24) Shingles out of meds.
25) Another alcoholic psych patient. Every racial slur . Where is my five foot physician colleague? This has his name all over it.
26) MVA – refusing evaluation. Brought in by BLS
27) Chronic back pain – seen recently. PMD won’t treat pain. “Nobody understands me”
28) Another drunk. “I want to go to Kosovo so I can fight for my country….I want to be a hero…..I don’t know where Kosovo is….do you know?” Patient can barely stand up straight let alone be trusted with a rifle.
Thus, in an Emergency Department which has a volume usual of 120 patients or more a day, since 2:00 pm today, that is our total census. Of this census, 5 via ambulance total.
I dare say that after the salt ladened ham, seven fishes, alcohol, and over eating, none of us will be able to make a similar entry tomorrow.
Merry Christmas to everyone from my staff and colleagues at the Emergency Department!
ADDENDUM: The above represented the time window from 2pm to approximately 8pm. The ER exploded at about 9pm. There were probably more police with people in custody in the ED that night than were manning the local stations. The psych unit exploded.
As I head in to work now, I expect no different. The doctor’s offices have been closed, those that should have been in yesterday probably have delayed to the point that they can’t hold out much longer, and, of course, the usual weekend crowd.