What was the WORST thing a patient has been brought to ER for?

MassED, BSN, RN · Jul 30, 2008

I don't have any great success trauma stories like what you quoted in the original post, those are prettty awesome. Don't hear stuff like that enough....

RN_in_SC · Jul 30, 2008

Ok, I have to put something because this thread is depressing!

It wasn't in the ED, but in the Neuro ICU where I was working.

80+ year old man in great physical shape. Was out for a walk, got dizzy, fell - subdural hematoma.

He was in a rural area, so it took a while for him to get to our hospital in the city. Came in for crani.

I took care of him for 2 weeks. First 10 days had a GCS of 3-4. Doctors convinced family to do a trach and PEG tube. Daughter postponed it two days.

Meanwhile he sometimes responded to commands. "open your eyes", "give thumbs up", "wiggle your toes".

RT came to pull tube (in prep for trach) - and he breathed on his own. Then he started responding to commands and questions and trying to speak.

The family and I were jumping for joy and that was the only time I cried working in the ICU - out of happiness. There were a lot of bad outcomes and that was the usual case - not much hope.

Within 48 hours he was transferred to a rehab facility. He is back at home with girlfriend and family and doing fine.

rph3664 · Jul 30, 2008

The worst trauma I have heard about did not have a happy ending BECAUSE the patient survived (IMO). This story was in the newspaper and is on the Internet now, so I will post it here.

In the late 1990s, I worked at a hospital in another city, and they brought a 19-year-old newly married man into the hospital with what was initially described as a crush injury to his legs from an industrial trash compactor. We later found out that his legs had been amputated at the hip (although I never found out whether it was at the site or later) and his entire pelvic area was crushed. I moved away before he was discharged, and since he had a distinctive name, I Googled it a few years later when I got Internet access.

He had a permanent urostomy and colostomy, but the website did not go into detail as to what happened to his sexual organs. I assume he lost those as well. He had to get around on a stretcher because any attempts to put him in a wheelchair led to skin breakdown, and he also had to live in a temperature-controlled environment because he could not regulate his temperature. He divorced his wife, against her wishes, because he felt she needed a "complete" man, and worker's compensation paid for him to live in a nursing home, with a custom-fitted room for him. He won an $800,000 settlement against his employer as well.

Even a persistent vegetative state wouldn't be as bad as this. :sniff:

MassED, BSN, RN · Jul 30, 2008

The worst trauma I have heard about did not have a happy ending BECAUSE the patient survived (IMO). This story was in the newspaper and is on the Internet now, so I will post it here.
In the late 1990s, I worked at a hospital in another city, and they brought a 19-year-old newly married man into the hospital with what was initially described as a crush injury to his legs from an industrial trash compactor. We later found out that his legs had been amputated at the hip (although I never found out whether it was at the site or later) and his entire pelvic area was crushed. I moved away before he was discharged, and since he had a distinctive name, I Googled it a few years later when I got Internet access.
He had a permanent urostomy and colostomy, but the website did not go into detail as to what happened to his sexual organs. I assume he lost those as well. He had to get around on a stretcher because any attempts to put him in a wheelchair led to skin breakdown, and he also had to live in a temperature-controlled environment because he could not regulate his temperature. He divorced his wife, against her wishes, because he felt she needed a "complete" man, and worker's compensation paid for him to live in a nursing home, with a custom-fitted room for him. He won an $800,000 settlement against his employer as well.
Even a persistent vegetative state wouldn't be as bad as this.

I can see the rationale for the man to let his wife go - what kind of life would that have been for her.... even if there was a great deal of love. I can understand why he did that. I am sure that if she loved him, divorce or no divorce, she'd stick around. That is a rough story and outcome. :down:

Blove86 · Jul 30, 2008

That poor man, I truly believe everything happens for a reason, Lord willing he finds out!

chicagobsn · Jul 31, 2008

Miarose~

I think its healthy to have a fear of the unknown...and to be nervous. We are all human, and things are hard to deal with...anywhere you go in nursing. Im fearful of what I will get and what will happen. My fear keeps me on my toes..to double, triple, quadruple check my meds...allergies, reactions of medications the pts who come in and just dont look right, to the low and high heart rates...BPs etc etc etc then I check again...and that alone has helped me keep me and my patients safe.

I do think its when someone thinks they know it all...or doesnt have that fear anymore that they become at risk for mistakes. We all make mistakes...its just the kind of mistakes you make can alter someones life and health status. When you get your job in the ER...just ask ask ask ask ask then ask some more. Your going to see such a variety of illnesses and diseases...that you cant possibly remember or know all of it. There are many meds...look them up if your not sure! Its been 5 yrs, and I look meds up in my med book all the time. Cant be to safe! I also ask the more experienced nurses and the docs about the diseases that I encounter. Knowing why you are doing certain tests and the rationale behind it and what the results indicate will help you help your patients even more.

This type of practice will give you the confidence, patience, knowledge and courage as a nurse! You will do great...and just remember...when it all gets to hectic...just take a second, breathe and refocus. you can do it.

Good luck to you! Keep us posted

MassED, BSN, RN · Jul 31, 2008

A very obese lady who sat in her recliner and could not get out. Several days later, her family found her and called 911. In our ER, we quickly discovered that thousands of maggots had decided to live under her breasts and abdominal folds! Not a pleasant site.

:barf01:

MassED, BSN, RN · Jul 31, 2008

Here you Go I got a Bad One...
I was interning down in the ER when I got a 32 yr old man who came in with a prolapse rectum...
The surgeons had to put a colostomy in...
2 weeks later he came back in with a prolapse colon...
Apparently after we got the scoop... The man was a homosexual... His partner Screwed him so much his rectum prolapsed
then after the surgery... His partner decided to use the colostomy site for his plessures...

oh that is so nasty.... and my sick humor, I was laughing.... but it's still so nasty.

MassED, BSN, RN · Jul 31, 2008

decapitation from a boating accident...

hope that didn't come into the ER.... couldn't do anything anyway....

MassED, BSN, RN · Jul 31, 2008

Exactly.
And how many babies die in cribs in other rooms compared to the number of babies who die while co-sleeping safely?
And there is research showing cosleeping may benefit/prevent SIDS, r/t mama's breathing "reminding" baby to breathe, ect....
Back on topic... kudos to all ER nurses! You rock.

I also had my babies in bed, but I would prevent them from being too close to my very sound sleeping husband. I would never sleep well, always one eye open when they were in the bed. It was exhausting worrying about them - of course I knew about smothering and cosleeping issues. My boys are 8 and 5 and I STILL find I have nightmares that one of them will be in the bed and I think they are being suffocated by blankets, comforters, or my husband lying on them. It's a fear that will never go away, I'm sure. I even worry about the darn cat.... geeesh.

MassED, BSN, RN · Jul 31, 2008

a woman and her two children, apparently attempting to leave home quickly (we figured the father was abusive) about 3:30am or so... mom and kids are in their PJ's and peels out of the driveway, not paying attention that a semi is heading towards her. All in the car were killed on scene. My charge nurse said the kids (2 and 3, I think) looked like they were sleeing in the morgue, perfectly without any marks or bruises. I understand the truck driver was beyond help, so grief-stricken.... the driver couldn't have stopped or swerved any other way to prevent running into them given that she pulled her car out right in front of the truck.

lupin · Aug 1, 2008

I forgot this one in my first post:

We hear from the PD there is a bad MVC on a well-known curvy road. We've had pts from MVC's on that road before, rollovers, going too fast that sort of thing. We get incoded that they are bringing three DOAs and two lacerations in from the accident. The three DOAs were a grandmother, mother, and 15 yr old daughter, the daughter a well-known local girl from pageants and almost always won homecoming for her high school (small-town). The two lacs were the driver and passenger from the other vehicle. The DOAs were brought in and I got to learn how to do postmortem blood draws that day. The 15 yr old looked like she was sleeping, no visible trauma but I just couldn't touch her. The mom and grandmom were like moving bags of jello around. This was two days after Christmas, the Dad was in the local prison, Stepdad was out on the road as a trucker so the only next of kin was the 18 yr old stepbrother, who had to come down and identify them. It was so sad. The local sherriff and chaplain at the hospital went in with him and sat with him until the extended family came in. Half the local school was there and the high school principal even showed up. Have no idea how they found out (again small town and half have scanners). But I just went home and cried that night. The thought of the sherriff having to tell the Dad his daughter was dead and the Stepdad just out working and his wife and stepdaughter are wiped out while he's gone. Sometimes it's too much.

The cause of the accident was speeding by the grandmother, all were wearing seat belts. The other two from the accident just cried the whole time. It really messed up the driver. He just kept saying he was sorry, and it wasn't even his fault.