The weak and dizzy patient is the bane of emergency medicine.Both common and nebulous, the weak and dizzy haunt me. Often when I am asked what kinds of cases I have been seeing in the ER, I can only remember the ones who were weak and dizzy. Some are more weak than dizzy, others more dizzy than weak.
And of course, these symptoms can represent something absolutely life threatening, or nothing at all. Naturally, the weak and dizzy patient is usually about 90 years old, thereby increasing the probability of a serious cause, and decreasing the patients ability to describe the symptoms. Lots of tests are required to rule out bad stuff, unless it’s a simple urinary tract infection. I’ll admit I have shouted “YES!” and pumped my fist when the urine came back showing infection on a weak and dizzy patient, thereby saving lots of tests, and giving me a decent diagnosis. I might have done this more than once.
When we discuss health care reform, we need to determine what to do with all the weak and dizzy patients. One solution might be qualified social workers which I read about on ER Nursey. Or maybe I will propose a regional center, someplace in the desert, where thousands of patients move efficiently through a series of conveyor belts, and pneumatic tubes. At junctions they may get a urine test, or blood work, or a CT scan. Automatically, they would be shunted towards their ultimate disposition and treatment–perhaps a comfy bed and some antibiotics, or maybe a poolside lounge chair and a Long Island iced tea.
Of course this facility will need a medical director. . .
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