Triage Nightmare!
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On a busy Sunday afternoon, 17 people in the waiting room. The main ED is swamped, every inch of hall space is used up. 3 people on stretchers outside triage with IVs running and being medicated for abdominal pain.
ER doc coming out periodically to examine patients at my behest, and against his will as he thinks we should be on "divert"...and has spent the last 2 hours trying to sell that to the administrator on call...
Get the picture?
So, just when things could not get anymore out of hand, a 43 y/o guy comes to the desk and says he hit his head 3 days ago and is still "a little dizzy"...(big deal)..."take a seat...be with you in a minute." I watched him walk to his seat...his gait was ataxic...he "plopped" down in the chair. Something made me walk over to him and do a cursory neuro exam.
I checked his hand grasps...right stronger than left...i took him to the triage room...looked at his eyes...right eye...ok.....left eye...not ok...divergent with minimally reactive pupil.
I put him on a stretcher, pushed him to the ED and put him in front of the ED doc. Asked the clerk to call CT and tell them to expect me in 10 minutes...
The CT showed a SDH...The guy was in the OR 25 minutes after he walked through the door...He's in the ICU...his eyes no longer move independently. He will go to rehab at the end of the week...hid daughter graduates from high school this June...he'll be there to see it.
After I pushed the guy up to the OR...I went back to triage...on the way...I said a little prayer of thanks...
Ok...who's next!