Monday, May 2, 2011

Day 2 in the Room of Emergencies (AKA: ER)

I have to believe that at one time the Emergency Room truly fulfilled its name.

Maybe it's because I'm a PICU nurse at heart, and we truly do care for PICU patients. Once they no longer fit that criteria, they go to the general floor.

However, the ER is definitely NOT that way!! Apparently anyone can come in, at anytime of day or night, for any reason.

Your kid chops his finger off? Bring him to the ER!

Your lovely daughter drank your entire bottle of perfume? Take her right to the ER!

Your 2 year old has a cold? Welcome to the ER!

Your four year old is crying too much? Oh yeah, ER!

Stubbed toe? Ringworm? Rash? Definite ER!!

You would think the average person reading the above list would be able to differentiate between the appropriate ER trips, and the not so appropriate ones! But I'm begging to differ!! People bring their child into the ER for the SILLIEST reasons ever!!

Take Ms. Black for example (name totally made up). She decides that her 8 year old son who has autism has been acting "all wrong" for the last 2 weeks...ever since he got bit by an unknown animal in their house. So she brings him to the ER.

When trying to gather all the information about what brought them their, we had to revisit the whole "animal bite" incident for which they were in the ER 2 weeks ago. Apparently some animal in their house (maybe a rat, maybe a possum, maybe a raccoon) bit the kids hand right by the thumb.

Now first of all, before we move many people do you know have possums or racoons routinely in the house...and close enough to biting distance!? Apparently this lady says they come in all the time and she sees their footprints on their walls when they wake up in the mornings.

So now they are wall walking, not supposed to be in the house, animals.

As a side note, she also said that the toys she puts away at night are all over the living room floor int he morning too. Great, now we're dealing with a possum/coon who likes to play with 8 year old toys in the middle of the night. Not that the 8 year old is getting out of bed to play. Of course not!

So back to the bite. The "wound" if it could even be called that was cleaned, a steri-strip was placed, a few labs were run, and the patient was sent home.

However, the patient is now in the ER because Ms. Black says that "The venom of whatever bit my son is turning him the same. He's been biting me all week long!"

Then she throws in there that he has rabies too.

Good news for the boy. After a thorough physical exam, he is 100% fine. He is acting appropriately for an 8 year old with autism, his lungs were as clear as a bell, heart strong, and rabies symptoms definitely negative!

As I'm telling her all this, and telling her that we would be sending her home with a recommendation to follow-up with her primary care provider who follows his autism, she asks if we can draw a CBC.

"No ma'am, there is no indication of drawing that lab."

Then she brings up the fact that his "urine smells bad, real bad"- to which, ironically enough the patient yells "STINKY CHEESE!" Mind you, he hadn't spoken a word all visit! We discuss proper hygiene, especially as he is a bigger 8 year old who is wearning a diaper and probably sweats a lot.

She doesn't like that answer. She wants a urine dip done.

My answer would have been NO! The resident, just to appease her says, "Ma'am, I can almost guarantee you his urine will come back clean. But just to ease your nerves, if he pees in the cup, we'll run it."

She tells us "That's smart. I know he's got an infection. He definitely has vaginitis."

Hello...back it up!! HE'S got VAGINITIS!?!? Umm, I think not!!

So we run the urine, and wouldn't you's completely normal!!! Vaginitis negative : )

So after running 1 more test that I would have preferred, we finally send them out the door.

Thank you for visiting the ER. Please come again soon...I'm sure Ms. Black will!!!

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