From the monthly archives:
Overcrowded ER’s  are not just frustrating and inconvenient, they can be downright dangerous. This article from Kevin MD is a few years old, however, it offers some perspective and commentary of interest.
Potentially adding to the problem is another issue that he raised today on the availability of primary care physicians .
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Q: On television and in the movies, whenever someone gets stabbed in the stomach, they seem to die. Is that realistic?{ 0 comments }
“There’s a crackling in my ear! ”{ 11 comments }
People often ask if I frequently take care of sick or injured people when I am not at work. In fact, it happens all the time and it’s no big deal. However, one time in particular I shall never forget. My wife and I were attending a musical in San Francisco (“Les Miserables”) and the show was about to begin. We noticed a commotion suddenly over to the right of the theater and up in front. There were people standing up around a man who appeared to be down on the ground. I made my way over and found that the patient was a 350 pound man, unconscious, laying flat on the ground in full cardiac arrest. I must say that being in this situation, with absolutely no equipment on hand was very frightening indeed. I began to attend to him, and fortunately, paramedics arrived immediately. The patient needed to be intubated (have a tube put into his airway), but he had just finished a large dinner, and most of that was bubbling up into his mouth, making intubation quite difficult. I was able to just get a glimpse of his vocal cords, and passed the tube. We gave him epinephrine, atropine, and his heart starting beating again, and he started moving around. We loaded him onto the gurney and moved him out to the ambulance. At that point, the entire audience broke out into applause and cheers, either because we had saved the man, or because they were just happy the show was going to start. I looked up and realized we had been in full view of the audience the entire time. It was the only time I have ever been applauded for my work–and I must say, it felt great.{ 4 comments }
A word to the wise on your 21st birthday.
It is a time honored tradition for young people to celebrate their newly acquired drinking status by going out with their friends and drinking far more than they or their livers can handle. I have lost count of how many unfortunate 21 year olds I have seen in the sorry aftermath of their revelry. But I do know that young people who are extremely drunk are not funny or cute, despite what the movies would have us believe. ER nurses are never pleased when they have to take care of the ridiculously drunk young adult, because invariably they also must deal with vomit, urine, and attitude problems. Usually the patient has some relatively boisterous “friends” in tow, probably the characters that a few hours prior to arrival were shouting, “Drink, Drink, Drink!” But by far the biggest problem with the 21st birthday tradition is that people can get very sick or hurt from heavy drinking, especially if they are not used to it, and their friends are egging them on. I have treated patients with broken limbs, head injuries, dehydration, and even a fraternity member with hypothermia from being stranded outside by his brothers.
I recently treated a 21 year old who was already completely intoxicated when his friends encouraged him to gulp down a drink known as “Adios, Motherf—er.” The drink was so successful that he went into an unconscious state, and his friends ended up calling 911 when they could not revive him. He required IV fluids, and observation for several hours. His friends may have paid for the drinks, but I doubt seriously they picked up the ER tab. If you are about to turn 21 and are looking forward to a wild night with your friends, here’s my recommendation–pick your most responsible friend, ask him/her to watch out for you, and slide you into bed when you’ve had enough. Your brain and liver will thank you, and so will I.
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