Last monday, I had a lady come into triage with a godawful, pity-me limp. She proceeded to tell me that she had terrible pain from her low back radiating into her left leg. She offered up that maybe she had "over done it at her family picnic" the morning before. Then she said, "I think it might be sciatica!" (stage limp = 1st red flag, medical jargon from non-medical person = 2nd red flag). For some unknown reason, she felt she needed to share that she had had an MRI the previous thursday, but her Dr. didn't have the results yet. Now I am confused beyond reason....why did she have the MRI thursday, when the pain started Sunday am? (red flag #3). I simply told her that since it was now Monday, I would place her in a room, and call her PCP for the MRI results. Looking a bit nervous, she allowed me to place her in a room. I told her to get into a gown, and the Dr. would be in to see her shortly. She did get into the gown, then opened the door and laid back onto the cart. I called her PCP, and they said they would get back to me. A few minutes later, one of the nurses said, "Diane, you have a phone call from dr. so and so's office regarding the lady in bed #3". As I go to answer the phone, the patient appears on the other side of the desk, fully clothed (nt having seen the er dr yet), and proceeds into this tearful tyrant about her PCP having "washed his hands of me!" boo, hoo. As I am looking at her, her dr.'s office informs me that this lady did indeed have an MRI in April, however it was in 2002. I thank them, and hang up. Then the pt. tell me that her "othopedist" (red flag #45) "told me that if EVERYBODY in the world was taking oxycontin, then who would be left to govern the world?!!!" boo, hoo, hoo. I tell her, she hasn't even yet seen the ER dr. Would she like to return to her room to see him? She sniffs a few times, and goes into the room, only to return to the nurses desk a minute later, saying "I want to sign out AMA!" (another one of those medical jargon red flags". So, we sign her out...and upon cleaning the room, discover that the code cart key is broken, and the pre-filled valium syringes are gone. Great. BTW, another thing she had said in triage was "My co-worker dropped me off during my lunch break and will pick me up when I'm done" I hadn't even asked her how she got to the ER. She obviously Knew enough to say that, so that if she got narcs, we would think she had a ride. When she signed out AMA, she had her car keys in her hand.
