Saturday, 26 December 2015

12 days of Christmas in the ED

Working in A&E brings plenty of different experiences, here is a selection of true stories from the 12 days run up to Christmas.

On the first day of Christmas, the ED gave to me: a cockroach infestation in resus bay 3

On the second day of Christmas, the ED gave to me: a patient with a baseball bat to the face, and the chance to assist in a lateral canthotomy

On the third day of Christmas, the ED gave to me, a psychotic gentleman after losing a loved one in hospital , the questionable choice to bring the body to A&E due to a flooded morgue to help the patient come to terms, and the dire mistake and consequences of bringing the wrong body up to the ED.

On the fourth day of Christmas, the ED gave to me, many giggling nurses, several confusing PA calls, my name changed on the computer system to 'Bieber', and in inability to change it back until three

On the fifth day of Christmas, the ED gave to me: A patient who had been hit by a bike, a swollen and painful hand, an X-ray showing a dislocated trapezium bone, a referral to a surgeon who wasn't sure what the trapezium bone was, and the feeling that the MRCS must be pretty crappy. 

I am now, as you can tell, struggling, to keep fitting my recent experiences into this ridiculous format, and will just list the rest. This was a terrible idea to try and do this!

On the sixth day of Christmas, a patient presented having electrocuted himself with an iron, wearing a T-shirt emblazoned with 'what doesn't kill you makes you stronger'. The irony was lost on him. Perhaps he was going to turn into a superhero, with a super power of resisting the power of resisting literary techniques.

The seventh day of Christmas was not a good shift. I was called a 'dirty fingering heterosexual' by a furious patient, a very anxious man presented who thought he had cyanide poisoning from eating a bag of apricot seeds from a health food shop and refused to leave, and a patient snuck into the A&E toilet and cut her wrists, barricading herself inside.

The eighth day of Christmas started of promisingly with the ambulance service bringing in a patient coded as 'shooting/stabbing/penetrating wound', exciting the department to prepare for a trauma call, until it turned out it was a man who had dropped a kitchen knife on his foot.

On the ninth day of Christmas, a patient with dementia was bought in due to pneumonia. We were transferring them from the ambulance trolley onto one of the A&E beds, when the patient started taking a poo. The carer, who had come in from the nursing home, shouted 'catch it' and the nurse managed to grab the stick of stool mid-air out if instinct. With her bare hands. Merry Christmas...

The tenth day of Christmas was more positive, with a patient telling me they had named the pulmonary embolism they had developed after surgery 'Jeremy Hunt' as it was a "potentially fatal clot" and a drag queen attended with mallet finger after getting their fingers stuck together while gluing on their eyelashes.

They eleventh day of Christmas was a day of detective work.  A child presented having eaten berries from the garden of an unknown origin, but the mum had bought in the leaves from the plant (if only I had a botany degree as well, but good ol' google has the answers as always if you look hard enough). There was also the interesting conundrum of a patient presenting in acute alcohol withdrawal which can be very dangerous and even fatal unless the patient continues drinking, but with the added problem that she had been given a bail condition that she couldn't drink any alcohol, due to an assault, and if she did she would go back to prison. 

The twelfth day of Christmas started well, with plenty of gifts to the department of tasty food from the local Jewish ambulance service (Hatzola) and Muslim communities (interestingly we had many more gifts from groups that were not Christian), but then was ruined when I mistook the medical consultant for a patient who had come in with solvent abuse induced hallucinations, and told her that she needed to pull her act together and that we were not going to give her the glue back that we had confiscated... I am going to have to keep my head down until the New Year!