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My trip to the ER

Nurses General Nursing Article   posted

3ringnursing specializes in ICU; Telephone Triage Nurse.

I'm one of those people who would rather tough out just about anything at home, writhing in misery until it passes, then go to the ER. I once tried to ride out cholelithiasis - insisting it would pass ("Tis just a stomachache! I'll be fine.") before riding to the ER via EMS transport, hollering like I was having my leg sawed off 3 days later. You are reading page 2 of My trip to the ER. If you want to start from the beginning Go to First Page.

3ringnursing specializes in ICU; Telephone Triage Nurse.

Both the first and second times I was bitten by (confirmed) rabies positive kitties, I was SOOO glad I had been vaccinated. Only had to have boosters at the local hospital's infusion center (and PO abx). And even they were...not fun.

I had a bad bite (non rabid) once that I thought I had cleaned thoroughly...nurse Oranges thought she knew how to clean a deep puncture wound at home...?!?! Yeah, right.

A full week in the hospital on multiple IV abx and 2 surgical consults later I was finally ready to admit that NO cat bite should go untreated. EVER.

Pastuerella is nothing to screw around with. Glad you are ok!!

Okay, if you are admitting you thought you could clean it, then I will admit since it wasn't a deep bite (I've had deeper into my right wrist and the nerve in that spot - which feels like being hit by lightening) I actually harbored some hope it wasn't too bad - or that I even mistook nail punctures as a bite. I knew I was fooling myself that night though, the unmistakable slit in the skin is a dead give away for a fang puncture.

I was laying in bed the next morning thinking, "This isn't so bad" - then I bent my knee ... Ow, ow, ow, OWIE!!!

It's funny how sometimes we try to convince ourselves something isn't quite so bad (like when you are holding your amputated finger - just kidding!). :D

Ok, since we are being brutally honest 3 ring, let me take it one step further - I LET SOMEONE PUT PEROXIDE ON MY BITES.... I know, I know. I'm shaking my head in shame as I write. In my defense, it was many years ago, before they took peroxide out of the EDs, but, still. I should have known better. I was in "shock" (emotional shock) as I had been clawed on the face, neck, chest, arms, and bitten on the hands, BUT...that was no excuse to let them douse me with a substance that I KNEW delays healing, promotes scarring and promotes infection by killing healthy tissue.

I am not proud, and I wear the scars (even on my face) to this day. Never again.

Edited by Apples&Oranges

3ringnursing specializes in ICU; Telephone Triage Nurse.

Ok, since we are being brutally honest 3 ring, let me take it one step further - I LET SOMEONE PUT PEROXIDE ON MY BITES.... I know, I know. I'm shaking my head in shame as I write. In my defense, it was many years ago, before they took peroxide out of the EDs, but, still. I should have known better. I was in "shock" (emotional shock) as I had been clawed on the face, neck, chest, arms, and bitten on the hands, BUT...that was no excuse to let them douse me with a substance that I KNEW delays healing, promotes scarring and promotes infection by killing healthy tissue.

I am not proud, and I wear the scars (even on my face) to this day. Never again.

You are not the only one my dear A&O. I have done some truly spectacularly duffus things myself (case in point, letting down my guard near feral cats who were in the process of getting a mad-on).

Once in my very early 20's when Retin-A first came out on the market I used my mother's Rx on a pimple. It was extremely high dose, and Rx'd for her wrinkles (she was in her early 50's then - by the way, she didn't have any wrinkles!). Anyway, it's supposed to be used judiciously in very small amounts, and on a completely dry face.

Well, not only did I disregard the dry face part, but I used a HUGE amount over a series of days because it wasn't vanishing as fast as I thought it should (my thoughts then were if a little is good, then a whole lot is even better!).

It ended up eating a hole in my face! I no longer had a pimple to worry about, as now I had an actual wound 3x's the size of the original pimple. It was like a small crater actually.

It scabbed over and took a few months to completely heal (plus, my mom was furious I used half the tube of her expensive Rx Retin-A). She forbid me from ever touching it again - which was fine by me because it caused me great damage, and I still bear the faint pitting scar to the right of my chin to this day.

On a side note, my PCP wanted to Rx Retin-A cream to me recently for a lesion near my eyebrow. A parade of images flashed through my mind's eye and I freaked - I ended up opting for liquid nitrogen treatment at the dermatologist's office instead (who is making a mint off of me lately due to numerous superficial skin CA's inflicted from dumb decisions involving sunbathing, also in my early 20's).

I'm pretty secure in saying I think we have all caused ourselves more harm than good at least once trying to treat something.

Oh Geezus! Noooooooooooooooooooo!

Haha, also, I feel totally ripped off as I received nary a sandwich nor drink of water in more than 30 hours of ER time getting these shots.

3ringnursing specializes in ICU; Telephone Triage Nurse.

I hope you provided your praise directly to the hospital as well! :) It's always nice for the ER staff to hear positive feedback.

I think I need better glasses - I'm embarrassed to admit I thought your avatar picture was the Flying Dutchman from Spongebob Squarepants for months:

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I feel for you. My 4 year old tried to pet a raccoon yesterday. Almost was successful as it was trapped.

I totally can imagine your pain! Thanks for the story!

3ringnursing specializes in ICU; Telephone Triage Nurse.

I feel for you. My 4 year old tried to pet a raccoon yesterday. Almost was successful as it was trapped.

I totally can imagine your pain! Thanks for the story!

I had a TB skin test at a Walgreen's Minute Clinic one year when I didn't want to drive in my employer's administrative office which was about a 45 minute drive away (I work from home). The NP administering the skin test told me a story:

A few years ago she went home for lunch, and pulled into her garage of which she had left the roll up door open. In the corner sat a manky looking squirrel with a sparsely furred tail, like a bottle brush.

After getting out of her car she grabbed a broom from a corner and prepared to evict the interloper, striding confidently to where it sat watching her suspiciously with it's little twitchy eyes.

Apparently she thought she would chase it out of her homestead then go relax and grab a quick bite. Little did she know (that is sort if what happened) ...

When she was within 15 feet away from the squirrel it attacked - launching itself in an amazing arch it flew right onto her face, landing on her upper chest area, clinging to her uniform jacket. It also gave her a good bite in the right cheek, tangling in her hair in the process.

She dropped the broom, running in circles and blundering into stacks of items which went crashing to the floor in the mêlée, screaming like a banshee all the while.

The squirrel held on for the ride, chittering angrily.

She said she finally slipped in some liquid on the floor, dislodging the squirrel. It ran under a pile of downed boxes still chittering in triumph (apparently it had claimed her garage as it's territory and had been denning there).

Much the worse for wear, she got back into her car and shakily drove herself to the ER for the full rabies package and wound care for her face. She never made it back to work that afternoon - or the rest of the week.

She also had to call a wild life removal service for the territorial squirrel to finally rid herself of it, as it had moved in and claimed the garage as it's lair - spraying it thoroughly with urine.

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Davey Do specializes in Psych, CD, HH, Admin, LTC, OR, ER, Med Surge.

When she was within 15 feet away from the squirrel it attacked - launching itself in an amazing arch it flew right onto her face, landing on her upper chest area, clinging to her uniform jacket. It also gave her a good bite in the right cheek, tangling in her hair in the process

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3ringnursing specializes in ICU; Telephone Triage Nurse.

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"Stupid Human! I will spray you in the face - and your garage too!".

TriciaJ specializes in Psych, Corrections, Med-Surg, Ambulatory.

Squirrels don't carry rabies. Seriously.

Squirrels rarely carry rabies. If you want to take the chance that this wasn't the first squirrel case in a while, you're probably safe. But since untreated rabies is 100% fatal (or close enough), I think I'd just spring for the rabies package. That's just me.

3ringnursing specializes in ICU; Telephone Triage Nurse.

Squirrels don't carry rabies. Seriously.

Yeah, I was bit by a cat ... but after giving the squirrel bite story some consideration - and as Triciaj (and also a nurse friend of mine) pointed out, rabies untreated is 100% fatal - I think I too would just knuckle under and spring for the full rabies package (including scrumptious complementary turkey sandwich and ginger ale) just to be on the extra safe side.

Not everyone will agree with this, but I can't say that I find fault with the NP for her decision on that day given the circumstances (and I feel a tiny bit bad too privately thinking I'm glad it wasn't me for once, because all the weird crap seems to happen to me more often than not. I'm just relieved Fate gave me pass for once).

Pixie.RN specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN.

Squirrels rarely carry rabies. If you want to take the chance that this wasn't the first squirrel case in a while, you're probably safe. But since untreated rabies is 100% fatal (or close enough), I think I'd just spring for the rabies package. That's just me.

First squirrel case ever, not just in a while. :) There have been none in the US according to the CDC. I had an ED physician coworker who used to get on his soapbox about this! Those woodchucks, however! Lol. They are bad. I had a patient bitten by a squirrel, and the health department refused to treat her based on low risk. She came to the ER and requested treatment. As was our protocol, we called the health department, and they advised against it. She got it anyway, but it was probably more necessary for peace of mind than any real risk. It's a good thing my anti-squirrel-rabies friend wasn't there, he might have not given her the RIG and RabAvert combo!

I also take care of feral cats (anything too wild to be placed in a home by our local rescue agency)in my horse barn. I was bitten by one of my house cats (who was feeling very macho one day) and so I got to forego the rabies treatment but still got a raging cellulitis. The only thing worse is a human bite (more bacteria.)

Edited by LadysSolo
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3ringnursing specializes in ICU; Telephone Triage Nurse.

I also take care of feral cats (anything too wild to be placed in a home by our local rescue agency)in my horse barn. I was bitten by one of my house cats (who was feeling very macho one day) and so I got to forego the rabies treatment but still got a raging cellulitis. The only thing worse is a human bite (more bacteria.)

Ouch! I'm sorry.

Like this? (It came out so big, but I can't remove it)

Edited by 3ringnursing

Oh, much worse - I ignored it until it went up my whole forearm. (I tend to not take very good care of myself.)

Munch specializes in Med-Surg/Neuro/Oncology floor nursing..

I take care of the stray kitties in my neighborhood too as I am a huge cat lover. Actually a stray kitten showed up about 2 months ago and was the cutest, tiniest thing(looked like it had some Maine coon in it with a huge fluffy, wide tail, Maine and fuzzy ears) I fostered it and just found it a forever home..I have 3 adult cats of my own and believe me my big boy was NOT having it at all. Since it was a kitten and just so cute I wasn't giving up until it had a home..luckily my persistence paid off. Anyway I digress about my love of cats..

I never got big by a stray I did however get bit by my own a number of years ago. My cat liked to play Houdini and escape out the front door any chance he got. So one day he slipped outside with a friend of mine that just left. So I go outside to grab him and for a split second it was like he was a feral cat. He must have smelled another cat in the area..something that made him feel threatened. He layed into my hand really hard. My goodness the pain was horrendous it felt like it went deep into the bone...it really felt like my hand was fractured that's how badly it hurt. I had two puncture marks on my hand. So I did some self care..I will use my medical knowledge on myself! No need to seek medical attention! Well I was completely wrong. Even after cleaning it with some betadine 2 days later my hand was double its size, red like a fire engine and I was unable to move my pointer finger. I was off that week from work as my sister had just got married in Chicago otherwise I probably would have had one of the docs at work look at it in passing.

So I had to trek to my local ED(I work in an innercity hospital but live in the suburbs so going to my job would have been a nice commute and since I wasn't getting paid to go I decided to stay local). They wound up admitting me for 4 days for IV abx that's how bad it was. I was on oral abx after being discharged. All that from a cat bite! Lesson learned..cat bites are no joke..had I gotten medical attention right away some oral abx and I could have avoided the whole admission. But nope just like the OP I did not want to clog up the ED with such a frivolous complaint(frivolous in my eyes).

Davey Do specializes in Psych, CD, HH, Admin, LTC, OR, ER, Med Surge.

Ouch! I'm sorry.

Like this? (It came out so big, but I can't remove it)

Here's a kiss for your boo-boo, 3ring:

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