Work is Hazardous to My Health - page 2
I almost died today. A man comes into my busy level 1 trauma center with ALOC and no known cause. The sister says he has had a fever for the last couple of days and developed hives yesterday. The... Read More
Mar 17, '13You could have a career in writing! Great job, and I am glad you are OK. Many years ago we found out a co-worker of ours had bacterial meningitis. I didn't know how serious it was that we had all been exposed to her day in and out. Cipro was my friend.
It was super clear to me that OP was joking about blaming the medic. Really people, lighten up!!
Mar 18, '13This is the stuff of those TV medical shows where everything is jumpy camera angles, shocked facial expressions and drama.
Do you know how the patient is doing?
Mar 18, '13Fantastic case to demonstrate a whole bunch of stuff:
LOC - even for alcoholics - can NOT be taken for granted. Assumptions were made that delayed Rx.
Rash and CNS change is meningococcal meningitis until proven otherwise. Check for stiff neck ASAP.
Great service recovery: This guy is NOT on the curve for the presumptive diagnosis -> Lets W/U NOW. Probably saved his life, as hours count with this diagnosis and severity.
Inadvertent exposures to meningococcus and other agents: Get expert prevention advice and check CDC. Get prophylaxis. If as an employee, be sure to immediately notify supervisor and follow occupational exposure institutional guidelines...
Finally - coping with your own psychic trauma. Sharing this is helpful for recovery. If problems with sleep, relationships, work then you may need more help, so get it.
This could be a case in ! Way to go for sharing.
James Smeltzer, MD
Mar 18, '13Quote from MunkiRNOr you were never truly infected. The hyperbole here is almost intolerable.As the adrenaline starts to dissipate and my mind clears, it hits me, I ALMOST DIED TODAY! I almost died, and a little pill saved my life.
Quote from MunkiRNAs part of a risk management team, this attitude is what drives me up the wall. YOU allowed yourself to be distracted. YOU got in a hurry and didn't take the extra couple of seconds to protect yourself. Making excuses like this will lead you down the road to another incident. Take responsibility for your own safety. It's no one else's fault and your responsibility to use the tools provided.Now, we all agree this is really the medic students fault, because obviously they distracted me.
Mar 18, '13Some people need to chill out and learn how to read sarcasm and jokes.
OP, love your writing style, hyperbole and jokes included!
Mar 18, '13Clearly some people don't have much of a sense of humor :P
Here, let me help you guys:
Hugs to you OP, glad you are ok!
Mar 18, '13Loved the article, glad you are Ok.I clearly understood your writing style but by reading the comments posted, some people obviously didn't.
Mar 18, '13[QUOTE=usalsfyre;7230723]Or you were never truly infected. The hyperbole here is almost intolerable.
Agreed, on both points.
Funny how I just logged on to share a similar story though... just the other day...
Charge nurse wheels a young adult patient into my room, "weakness and body aches," she says to me. I look over at him and think "drug seeking heroin addict with crappy veins or REALLY sick." I drop what I'm doing and go over to pt. Pt had walked in stating "I don't feel good." Dark complexion but face distinctly purple. Charge nurse and I look at each other, she walks off. I say to pt "can you stand up? We need to get your clothes off, put you in a gown and get you into bed." Stands with assist, I am face to face with pt as I help remove shirt. Petechiae over back. Pt states "my neck hurts and I just feel horrible, I have for the last three days." I lay pt in the bed and immediately walk to the charge nurse. Pt is put in negative pressure room, new nurse takes over as I start documenting triage. We all know this is meningitis until proven otherwise. I finish triage, wash my hands and get back to my work. Rocephin 2g almost free flowed, vanco started, within hour pt apneic, tubed, shortly thereafter goes pulseless, almost all nurses are now working on pt, everyone has on N95 that we have been fit tested for. Significant other at bedside throughout hour and twenty minute code. By this time pt is in DIC, chest can barely be compressed, pt almost completely purple, about 40 minutes in doctor sums up interventions aloud (levo, dopamine, FFP, epis, bicarb, amio,etc) asks "does anyone have any objections to calling this code, all staff stops and thinks, significant other has just before this stepped out with primary nurse, one nurse states "Pt has a young child you guys, we gotta keep trying." Code resumes. Death pronounced 2 hours and 26 minutes after pt walked in. Confirmed Neiserria meningitidis A/Y. No one had to beg for prophylaxis. Infection control woke up early and came in, we all got our cipros and then two of us stayed over for four hours and, with masks on, triaged and prophylaxed 20 members of family that had seen pt at a BBQ two days before.
Coroner and Dept Public Health notified. Family a wreck, able to see pt only through glass of window. Truly macabre scene.
I went home and slept. Woke up around 8 pm (I work nights), first thought was of the pt, could see his face. I sighed, put on a suit and tie, (I love suits, makes up for working in PJs) and took a nice relaxing walk to the local wine bar. Ate a roasted Spanish pumpkin with the seeds and drank two glasses of Beaujolais, then had fresh pasta with a rabbit ragu and two glasses of Sangiovese. I sat there quietly, peacefully, thinking and enjoying the food and the wine, the fact that I was alive and marveling at that little tiny Cipro, thinking that Neisseria, the sun , all of us, the moon... we're all made up of them same elements, just in different arrangements. As I walked home I called my little brother and told him I loved him and that he is a punk for not calling our parents or seeing them as often as he should. The parents of two of our childhood friends have passed in the last few weeks, I reminded him.
I got home, undressed, brushed my teeth and laid down in bed. I picked up The Brothers Karamazov (modern translation by the husband and wife team, much better than Garnet's in my opinion). I finished Part I which ends with Alyosha praying before getting into bed:
... The confusion in his soul suddenly passed. "Lord, have mercy on them all today, unhappy and stormy as they are, preserve and guide them. All ways are yours: save them according to your ways. You are love, you will send joy to all!" Alyosha murmured, crossing himself and falling into a serene sleep.
Mar 18, '13I never thought the OP was actually BLAMING the medic student ... I just didn't care for the hyperbole. But as I said in an earlier post -- this is where all those great TV shows come from - writing like this!
Mar 18, '13Thank you again to everyone who read this in the spirit it was intended (I.e humor, satire, sarcasm, and a little hyperbole for good measure). To answer Altra's question, I have not had the opportunity to check on him, but the doctors were hopeful at the time.
Mar 18, '13I had the same scare when I worked in the ED. All my patients were discharged and I looked around to see which one of my co-workers can use my help. One of my co-workers asked if I could transport his ICU patient to their room. I thought, no prob. I got the patient upstairs and got the receiving nurse. While helping to put the patient in their ICU bed, I noticed everyone was wearing PPE except me. They stated where is your PPE? I said "why do I need that?" They replied " Because the patient has a pending LP result". I wanted to die. In the ED where I worked the nurses rarely wore PPE, the nurse I was helping didn't even bother to tell me. I let him have it.