do you wanna die???

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We had a patient the other day that had to be fiberopticaly intubated due to a fractured C-spine. he also had a head truama so was a little loopy.

he was biting on his tube. and his nurse would periodically yell at him saying" if you bite through that you'll die!!!!!" .

later I was walking my patient (walky talky) to the bathroom. as we passed the naughty patiens room we heard the nurse yell loudly" STOP or youll DIE". my patient looked at me with a very suprised look. I couldn't stop laughing for hours..

later when the patient did bite through his tube the anesthesiologist was standing over him yelling ( just as my patient was heading to the bathroom again) "Do you want to Die" "this is very serious" , " you could DIE" "hold still or youll Die" I almost wet my pants I was lauging so hard>

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The other day the main door to our unit was broken, you could unlock it and get in from the outside, but you couldn't get it to open from the inside. We have to let patients in and out of the door so one time when one of my co-workers went to let a patient in, she yelled through the door for him to "Go to the side". To me at the other end of the hall, it sounded like she was telling him to "Go to the light".

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That's hilarious! OTFL picturing the look on that patients face. I love those days when you're lucky enough to catch something like that to keep you laughing all night. Trying to think of some good ones.

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Originally posted by alansmith52

the anesthesiologist was standing over him yelling ( just as my patient was heading to the bathroom again) "Do you want to Die" "this is very serious" , " you could DIE" "hold still or youll Die" I almost wet my pants I was lauging so hard>

Is this a joke? Am I not getting it? This is not the way to talk to a patient, and it hardly seems like a laughing matter.

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you gotta relize that head injured patients arn't really "with us". you have to yell and use simple phrases. aside from not speaking english this guy didn't have the congnition to relize what he was doing.

and the truth is. biting through your endotracheal tube and not being able to be re-tubed could kill you.

I mean if I am doing something that could kill me. by all means let me know. don't spare my feelings.

patients come and go.. we have to work togther.

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Granted the guy wasn't with the program but how about a bite block. He clearly couldn't follow directions. We have a lot of head bleeds on my unit and having worked Trauma years ago, it doesn't matter if your head is injured from getting hit or from a bleed, the effect is the same. They don't have a clue as to what they are doing. So you pop in the bite block and they can no longer chew the tube in half. It also sounds like that poor patient wasn't sedated enough.

I had a trauma surgeon say something equally as stupid as the above. She went into the patient and screamed at the top of her lungs "If you don't stop moving like that I am going to paralyze you". I said to her "you do realize that if this patient can think at all that she is thinking you are going to wrap your hands around her neck and twist till she is paralyzed. The general public doesn't know paralysis comes in a bottle!" She just walked out in a huff. The patient was clueless.

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lol... thats good. yeah for some reason I don't remember why they didn't use a bite block. we try not to sedate some patients so that we can get some kind of an exam on them. when they re-intubated this guy no sedation was used on purpose.

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Sounds like a bite block and some propofol could've worked wonders for this pt...propofol is nice, b/c almost as soon as you turn it off, the pt wakes up and you can get your assessment, unlike MS/Ativan. Good for weaning too.

WHY did they use no sedation on purpose when they reintubated him????? Some sort of "punishment for a pt with no idea what he's doing," or am I really missing something here?

If he was awake, sounds like he'd be fighting, coughing, and gagging, all of which can cause further c-spine injury, as well as increase his ICP...killing said pt, courtesy of the hospital staff.

???

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Quote:

"aside from not speaking english this guy didn't have the congnition to relize what he was doing."

This guy didn't even speak English? Then how is supposed to know what people are screaming into his face? No wonder he was agitated and biting on the ETT...

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

WHAT is SO FUNNY about this? what if this were your father/grandfather? Would it be just as hilarious?

No sense of humor here, I guess. This Man is in a strange place and a strange tongue is spoken all around him.....he is sick, unable to breathe on his own, and prolly scared out of his mind (so he was not "with it", does this make it a humorous situation?). sounds like HELL ON EARTH TO ME. Sorry, I will be the stick-in-the-mud here; I find this callous, not funny at all! :-(:(

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Specializes in Critical Care.

Sounds like this patient needed a bite block and much better sedation, I know many docs don't like to sedate head injuries but if the situation is so serious they better rethink it. A nice propofol drip or ativan drip might help.

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Sorry alansmith...but I disagree with you.

I have worked in long term care and in NICU. In both places I have dealt with patients who didn't have it together mentally because they were at opposite ends on the life spectrum. Many times I'm sure I could have rightfully said something like, "If you don't hold still, you will die." But never once have I said it or yelled it to a patient.

And if I did it would NOT be something to laugh at or for other patients to hear.

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