Patients that made you go "How are you even alive?!"

[Cuddleswithpuddles]

Ever had a patient who had such a crazy medical history, insanely criticallabs, scary vital signs etc. that made you go, "How are you evenalive and talking to me?!"

Last night we had several such patients.

Every time I entered my patient's vital signs, the computer kept giving mea warning message saying that the numbers were outside the criticalrange and do I really, really want to record that. His MAP wasbasically incompatible with life. Equipment was validated many times.And yet the patient was totally asymptomatic and highly annoyed thatwe keep bothering him.

The phone was ringing and ringing when AM labs were up because we had somany critical values. Crazy electrolytes... and yet patients werestill in sinus rhythm.

A friend was hospitalized and his heart went into the 20s when heslept. No blocks, no cardiac disease, no symptoms... nada. He's justa fit guy, a genetic freak and a thorn in the side of the telemetry techs hehe.

The human body is amazing sometimes. Sometimes it finds a way to keep going despite the numbers.

So tell us about your patients who have made you go, "How are you even alive?!"

[RTsoonRN]

I'm not a nurse yet, almost there, i'm an RT, but we recently had a patient with a pCO2 of 181. I thought it was an error until it was confirmed by 2 machines. The patient was able to appropriately answer questions although the patient was "slightly" obtunded to say the least. Normal vites, normal neuro, but I just couldn't figure out how the hell she was even conscious.

[crn26]

I had a patient, who was on the sicker side, but there was a note in the chart that said not to call the cardiologist, unless the heart rate dips under 30. I was a new nurse at the time and this freaked me out. I kept checking his heart rate all night!! I was so glad when he was finally transferred to acute rehab!

[meanmaryjean, DNP, RN]

Guy in the ED with a BAC of .712 who proceeded to puke vodka and White Castles on me. I have never, in 30+ years of practice, smelled anything quite as vile as that.

Watched him walk out of the facility a few days later. He's probably still out there, pickled.

[Striving2BG8, BSN, RN]

I had an anorexic women of about 68lbs and maybe around 5'3-5'5. Nothing but skin and bone looks like a corpse when she sleeps. Very scary and sad to look at.

[MelissaLPN, ASN, LPN, RN]

I once had a little old lady come into the ER BP 300/150. I know because I did a manual myself!

I also had a guys bg so high the lab couldn't read it, he was on an insulin drip for 5 hours before the lab called with 1700.

I also had a guy fall from a roof, hit his head on a dumpster and sever his trachea, they were able to fish it out of his chest in surgery, I believe he went home.

[Tarabara]

I had an anorexic women of about 68lbs and maybe around 5'3-5'5. Nothing but skin and bone looks like a corpse when she sleeps. Very scary and sad to look at.

That reminded me, I had a pt with head/neck cancer, he was 6' 2" and weighed only 97 pounds. The poor man, it was heart breaking.

[kissafish4]

I had a patient come in with a potassium of 10.7. He complained of being "a little weak" otherwise completely asymptomatic. I've only had two patients in 18 years with a potassium greater than 10 and the first one didn't live to tell about it.

[Christy1019, ASN, RN]

I once had a little old lady come into the ER BP 300/150. I know because I did a manual myself!

I also had a guys bg so high the lab couldn't read it, he was on an insulin drip for 5 hours before the lab called with 1700.

I also had a guy fall from a roof, hit his head on a dumpster and sever his trachea, they were able to fish it out of his chest in surgery, I believe he went home.

Whoa, how did he manage to stay alive long enough to make it to surgery?

The ones that stand out to me:

Pt found in the snow, temp 28 degrees celsius w/pulse of 18, took my entire shift to therapeutically re-warm her w/the alsius.

BP 300/200

Etoh 0.65 pt walking, talking and fully oriented

Hgb 1.8 with no source of bleeding, his official diagnosis "severe anemia not normally compatible with life"

Serum glucose over 1800 on a regular basis in a 21yr old non-compliant diabetic pt who usually only needed a vent if her gluc went over 2300

Baseline Pulse ox 80% on a pt who needed a double lung transplant & was on 78% O2 via NC with some special O2 setup that I can't remember.

[BluegrassRN]

I ask this out of pure curiosity, as I am a very brittle diabetic. In many threads, not necessarily this one, but many I have seen previously, it almost seems that people think our blood sugar bottoming out is our fault for one reason or the next. Is that the case or am I misinterpreting what I am reading? Tone is so difficult to read over the web.

Some people don't manage their insulin or diet well; some people will drop from 150 to >50 with one unit of insulin while others require 10 units or more. I'm always amazed when one pt takes 10 units of levemir, and another takes 100. I think you can typically well which diabetics are which, particularly after you've spent some time with them. On this thread (and many others), I think people's comments have more to do with amazement at what the human body can survive.

[turnforthenurse, MSN, NP]

Patient in with hyperkalemia, was given kayexalate and was getting IV fluids @ 100cc/hr...checked the BP for 0400 vitals and it was 42/28 patient was completely asymptomatic.