What is the most interesting case you've seen in the ER?

Specialties Emergency

Published

Not necessarily just for the ER RN's... any case in the clinical setting.

Specializes in Hospice.

I have seen a few cases of calciphylaxis- calcification of small blood vessels that causes wet and dry non-healing wounds all over the body. Another terrible and painful disease.

This is the WORST disease I have ever seen. In 3 years I have had 3 CJD patients, all in their 50s. They go from fine to dead in less than 6 months, and the restlessness is incredibly heart breaking.

I am curious as to how you have encountered so many cases of CJD. Do you work in an area with an outbreak of it?

I would never wish for someone to contract CJD but I do have a morbid curiosity about this condition.

Specializes in Urgent Care NP, Emergency Nursing, Camp Nursing.
Had this guy walk in claiming overdose in tylenol. Girfriend problems, yada yada. Total OD work up. Level was not high as tylenol had no been in system long enough. And he of course seemed fine.

As it turned out the guy had beat his girlfriend in the head with a hammer and she was in the hospital in another city.

About 30 minutes later, he decides to go AMA. I explain to him about tylenol toxicity, etc. Not having it. he's going. I call the cops, try to have him taken into protective custody, cops refuse. His mother arrives to take him home.

I explain to him, mama, and the cops that this is a long, slow, ugly death. He's insists he will go to the ER where girlfriend is, he just "loves her so much he has to see her", hammer notwithstanding. Mama says she will take him to the ER there. He signs out AMA and is gone.

Later we hear: long, slow, ugly death.

You can't fix 'em all.

If that had happened in my state, the ED staff could've had him involuntarily admitted as he'd displayed self-harming behavior. On the other hand, I can see why the cops weren't terribly concerned about a guy who'd hit his gf upside the head with a hammer dying a long, slow, ugly death.

Specializes in ER.
Had this guy walk in claiming overdose in tylenol. Girfriend problems, yada yada. Total OD work up. Level was not high as tylenol had no been in system long enough. And he of course seemed fine.

As it turned out the guy had beat his girlfriend in the head with a hammer and she was in the hospital in another city.

About 30 minutes later, he decides to go AMA. I explain to him about tylenol toxicity, etc. Not having it. he's going. I call the cops, try to have him taken into protective custody, cops refuse. His mother arrives to take him home.

I explain to him, mama, and the cops that this is a long, slow, ugly death. He's insists he will go to the ER where girlfriend is, he just "loves her so much he has to see her", hammer notwithstanding. Mama says she will take him to the ER there. He signs out AMA and is gone.

Later we hear: long, slow, ugly death.

You can't fix 'em all.

Legal hold for this one! A danger to himself and others. Oh well!

The dissecting aneurysm recently was an interesting case. No back pain, really strange.

Specializes in Med/Surg.
I am curious as to how you have encountered so many cases of CJD. Do you work in an area with an outbreak of it?

I would never wish for someone to contract CJD but I do have a morbid curiosity about this condition.

You're not the only one! I've spent hours upon hours researching prion diseases because I find them so fascinating.

Specializes in NICU.

A baby with a pentaology of cantrell variant. Insetead of a sternal cleft, he had no sternum. You could see his heart beating and it was so bizzarre. When he would sneeze, first he would suck in and the skin would wrap around the sides of his heart and when he would exhale on the sneeze, his heart would come out about an inch over his ribs. I was so afraid his heart would come flying out of his chest. They made him a pseudo sternum with a titanium plate and wires. He did pretty well and was a sweet happy baby. I've never had a patient before, whose HR I could count by just watching him.

Specializes in Pediatrics, ER.
A baby with a pentaology of cantrell variant. Insetead of a sternal cleft, he had no sternum. You could see his heart beating and it was so bizzarre. When he would sneeze, first he would suck in and the skin would wrap around the sides of his heart and when he would exhale on the sneeze, his heart would come out about an inch over his ribs. I was so afraid his heart would come flying out of his chest. They made him a pseudo sternum with a titanium plate and wires. He did pretty well and was a sweet happy baby. I've never had a patient before, whose HR I could count by just watching him.

Teeny, I've taken care of one baby with this anomaly who had the same exact thing...no sternum at all! They did not make him a new sternum though, he has a chest vest instead.

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Bad cocaine + cardiac arrest + seizures = patients who are darn near impossible to sedate! Ended up putting that one on a vec drip. Ugh.

Had a patient recently on whom I had to do an ABG. Assessed one hand/wrist, saw lots of scarring around the base of the thumb/wrist, did ABG on the other side. Chatted with patient about what caused the scarring, and he tells me he was born with an extra thumb. I said, "OMG, and you LET THEM REMOVE IT?" Hahahaha! One of my medics said, "Wow, think how awesome he'd be at Gears of War with an extra thumb..." Dang, and I keep waiting for my third arm to evolve in response to need, isn't that how evolution works?! I would think a third thumb would be pretty advantageous...

Specializes in LTC, Med-Surge, Ortho.
1. Abdominal compartment syndrome in a 12 year old. Tragic outcome on that one. 2. Mesenteric venous thrombus resulting in ischemia and necrosis of the entire large and small intestine caused by BCP's. Also tragic outcome. 3.Old guy. Full arrest in the field, completely smurfed from the chest up. No cardiac activity on US after multiple rounds. Asystole on monitor. Went in to do morgue care 30 minutes after code called and ALL care stopped. Ears now pink and patient with slow but spontaneous respirations. Saw him 3 days later outside smoking!

Wow!!!! what a miracle!!!:nurse:

Specializes in med-surg, psych, ER, school nurse-CRNP.
The weird thing is we not only coded him but pronounced him after being assessed by multiple skilled medical practitioners and an US confirmation of no cardiac movement and we had stopped all care for a prolonged period of time. I was in and out of the room afterward cleaning up and whatnot and he was still dead. It wasn't until about 30 minutes later when I went in and noticed subtle changes like the tips of his ears were pink that I realized something had happened. I threw open the curtain and yelled out "Dr. N he's aliiiiiiiiiiiiiiiive!"

I gotta know, what was Dr. N's reaction to THAT?

Specializes in ICU, Public Health.
A baby with a pentaology of cantrell variant. Insetead of a sternal cleft, he had no sternum. You could see his heart beating and it was so bizzarre. When he would sneeze, first he would suck in and the skin would wrap around the sides of his heart and when he would exhale on the sneeze, his heart would come out about an inch over his ribs. I was so afraid his heart would come flying out of his chest. They made him a pseudo sternum with a titanium plate and wires. He did pretty well and was a sweet happy baby. I've never had a patient before, whose HR I could count by just watching him.

Holy Sh!t.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Had a traume come in with possible disected aorta and a weird report from the medics.....when I was trying to hook the patient up something wasn't right.....the patient had true dextrocardia(situs inversus).....everything was filpped to the opposite side of his chest. So of course his heart tones were muffled....we were listening to the wrong side of his chest.

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