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

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

Specializes in Emergency!.

You guys all have great stories.

Mine is from when I did a shadow day in the ER as part of my new nursing orientation. I had previously worked in the ER as an aide before I graduated nursing school so to be honest I didn't expect to see much else than the usual. Boy was I wrong!

We had a patient collapse outside the ER doors, diaphoretic, bad color...looked like the typical MI patient. So we get him into probably one of the smallest rooms our ED has because it was the only one available and hook him up to BP cuffs and an EKG. The EKG was normal, BP was low though (I forget what it was). We then get the story that this guy was drunk the night before and took a tumble down the stairs (and even broke the railing). He got himself up and just went to bed to sleep it off. That morning he really didn't feel great so he drove to the ED, while in the parking lot he coughed or did something and felt a 'pop' in his chest and felt slightly better so he turned around and went to work. He comes back in a couple hours later feeling worse and we pick up again with him collapsing outside of the ED. Chest x-ray shows huge hemo-pneumotorax. We are not a trauma hospital so we start the process of getting him ready for transfer. It just so happened that one of the pulmonary docs was in the room next door, they did an emergency Chest tube. The doc didn't hook him up to the drainage canister before unclamping the tube, blood went EVERYWHERE! They finally got him connected, started blood and called for transfer. In about 15 of being in the ED with the CT in place he put out 2 liters and the canister had to be changed before he was transferred to the other hospital. The whole time he was in this room there was about 5-10 nurses and staff, and this room was tiny!

Not t

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Specializes in ED.

When I worked on the floor I had a pt with CJD. 50 something woman, came in walking and talking, within a week had detioriated to unable to walk, speak or do anything. They think she got the disease from deer meat. Since then I refuse to touch venison. Also on the floor had a 54 year old woman, for observation due to chest pain. EKG normal, enzymes flat. Sitting up in bed watching tv talking on the phone and ringing the call bell every 5 minutes. Started to complain of back pain (she had chronic back pain and was on all kinds of pain meds). I decided to do vs and an ekg before giving her any pain meds. EKG normal, but BP was low. Grabbed some saline, called the doc to come take a look at the pt. Now the pt is pale, diaphoretic and BP in the 70's. Doc comes over, assesses the pt and calls surgery. BP continues to drop and pt becomes lethargic. They get her to surgery and find a ruptured kidney. I believe she died on the table.

In the ED, I have seen too many weird and interesting cases to count. Every day is an adventure.

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Specializes in EP/Cath Lab, E.R. I.C.U, and IVR.

The most interesting case I have ever seen and will never forget was an ER patient, that was kind, friendly, and stated "Keep that Vicodin perscription. I'll just take Tylenol and Motrin!" Weird huh.

Jonathan RN

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An elderly lady came in on a backboard having had a syncopal episode and fell in her washroom. We were about log roll her off the backboard when we noticed fluid at the head of the board and also "a rotten stench" coming from her head (I was at the head). The ER physician removed her wig and the entire crown of head/cranial area was erroded; almost totally eaten away. You could see what appears to be brain pulsating. I am sorry to say this but it was like an alien! I was totally horrified I had not see anything like this before. She also had a lot white cream and cottony stuff over it seems like she was trying to do her own dressing. She had to have at least 6 weeks of Abx before surgery would touch her.

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Pt comes in a trauma, was shanked at a club. Per EMS, nobody knew he was stabbed, only saw him fall to the ground. Lights come on in the club, dude found lying down not moving. Police was called first, they arrived and then saw dude bleeding just barely from chest area. EMS called, dude is now agonal breathing.

Dude is now brought to ER, being bagged in the process, goes into PEA while being transferred to trauma cart. Two small puncture wounds noted to chest and upper abdomen. CPR in progress. Ultrasound of heart done, shows classic cardiac tamponade.

Attempt for cardiac centasis done, unsuccessful. Pt's chest is cracked in trauma bay. A blood clot the size of a basketball falls onto floor. Hole noted to ventricle of heart. Trauma surgeon sews up hole in heart right there while RN is pumping pt's heart. Pt gets eight units of blood in trauma bay. Pt rushed to surgery. Pt's heart never stopped beating, but continued to lose pulses.

Pt gets washed out in surgery, taken to ICU. Walks out of hospital one week later, A&OX3, neurologically in tact. Remembers being at club, getting into altercation with "some other dude" and waking up in the hospital on the Stepdown unit.

Talk about luck!

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Specializes in Hospice, ER.

I love the ED because we get such interesting cases that lead to so much learning. Keep up the great posts!

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Pt comes in a trauma, was shanked at a club. Per EMS, nobody knew he was stabbed, only saw him fall to the ground. Lights come on in the club, dude found lying down not moving. Police was called first, they arrived and then saw dude bleeding just barely from chest area. EMS called, dude is now agonal breathing.

Dude is now brought to ER, being bagged in the process, goes into PEA while being transferred to trauma cart. Two small puncture wounds noted to chest and upper abdomen. CPR in progress. Ultrasound of heart done, shows classic cardiac tamponade.

Attempt for cardiac centasis done, unsuccessful. Pt's chest is cracked in trauma bay. A blood clot the size of a basketball falls onto floor. Hole noted to ventricle of heart. Trauma surgeon sews up hole in heart right there while RN is pumping pt's heart. Pt gets eight units of blood in trauma bay. Pt rushed to surgery. Pt's heart never stopped beating, but continued to lose pulses.

Pt gets washed out in surgery, taken to ICU. Walks out of hospital one week later, A&OX3, neurologically in tact. Remembers being at club, getting into altercation with "some other dude" and waking up in the hospital on the Stepdown unit.

Talk about luck!

It's a story like this -- that once in a lifetime story -- that motivates me to get up and go to work every day.

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Specializes in Adult/Ped Emergency and Trauma.

A guy looking for a propane leak with a Coleman lantern.:jester:

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Specializes in Case Management.

Boston, cute, but if you can't take the thread seriously, hold in your thoughts!

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Specializes in ER, ICU.

(ER) We were working a young woman for near syncope and some floor nurse was helping start IVs (because we were busy). She was really digging around and the patient said she felt dizzy and quickly brady'd down to 17 seconds of asystole! Let's just say I stimulated her and she woke up without any trouble. The funniest part was the doc was complaining he couldn't find canned discharge instructions for "asystole".

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20 something female worth co low abdominal pain. Quite obese. 5 minutes baby born. Didn't know she was pregnant.

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Specializes in Emergency.

ha.. last week had a 12y/o boy put 30 little magnetic metal balls into his urethra. I'm not certain but I personally think that he maybe thought that when he peed they would shoot out like bullets? The poor fella was so embarassed... mum thought it was amusing..

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