Posted on 11/06/2006 12:04:18 AM PST by 60Gunner
Last night a "GDFD" (get drunk, fall down) was brought into the Emergency Department by aid car. She arrived, as most drunks do, bellowing obscenities and calling the staff vile names. And this young lady was also a spitter. Nice.
The law allows us to restrain a patient who poses a threat to himself or to staff, and our MD, a particularly excellent one, wasted no time in decreeing that it be made so. Security is always down there, so we summoned them to help us put the leathers and a spit sock on the young lady. We then shifted her over to our bed and unceremoniously strapped her down.
While all this was going on I was getting report from the very beleaguered-looking aid car crew. It seems that the patient was with her friends at a bachelorette party and the patient had a little more than her share of the alcoholic beverages, and when the staff decided that enough was enough about four shots of Jaegermeister ago, they cut her off. Little Miss Adventure got up to voice her dismay and wound up on her backside, having struck her head on the way down and picking up a nasty hematoma on the back of her head for a souvenir. "Thank God she's not bleeding so we don't have to sew her up," I thought.
It is interesting to note that although the young woman was maybe only 5 feet 3 inches tall and weighed perhaps a buck-five soaking wet, she fought like a wildcat in a burlap sack with a snake in it. Some people hold their liquor; with others, their liquor holds them. This lady was simply awash in the Nyquil-like stench of Jaeger.
The staff got Little Miss Adventure settled in (read: strapped down), and I obtained IV access (in this case with a big ol' 18-gauge in her antecubital fossa- that's the inner elbow for you laypersons) and drew blood for lab assays.
Oh, yeah. Little Miss Adventure was also a biter.
Now, we needed to get a urine toxicology screen as well. Since I am male, and this woman was in her twenties, obviously I was not the one to go in and do it. But I did inform her that yes, Nurse So-and-So was about to put a catheter down there.
"The ---- she is!" declared Little Miss Adventure.
Three minutes later, Nurse So-and-So walked out with a sample of urine, which she held up for me with a flourish, and I began charting.
Suddenly, someone behind me says, "230."
Then I hear, "Naw. She's tiny. 180."
Suddenly, numbers are being called out around the Nurse's desk as if it was the set of The Price is Right.
A brief explanation is called for here. Any time we get a GDFD into the Emergency Department, an informal bet about the blood alcohol content (BAC) immediately forms. It usually starts by someone saying, "249" (or 0.249). So without fail, within thirty seconds the entire front staff of the ED has a number except for me. After some prodding and some quiet consideration, I call out, "310."
"Get out!" says Nurse So-and-So. "She's maybe a hundred pounds soaking wet."
"No," says I, "I will bet you a pizza it's at least 300."
"Okay, Boy Wonder. What makes you so sure?"
"I think she's got a tolerance, that's what. Anyway, 310 is my number and I'm sticking with it."
"Have it your way," says Nurse So-and-So with a dismissive wave.
So all the while, Little Miss Adventure is screaming, kicking, spitting, and offering her pointed and graphic opinions about the lineage and sexual orientation of every staff member she who dared enter her room, even the poor little housekeeper who came in to change the linen bag. (It's a good thing she doesn't habla the Ingles, or at least much. Still, the darling woman came out of the room shaking her head and muttered, "stupid drunk b----."
About a half hour later, the labs came back. Yes, I was wrong. But we were all shocked. Her BAC was 0.418. What that means is that this little firecracker had herself a helluva tolerance for booze. I've seen worse, but not in a little chicky boom-boom as small as Little Miss Adventure. Her tox screen also showed THC. That's the groovy stuff found in marijuana.
Also around this time, a couple of the patient's girlfriends filtered sheepishly into the ED. They all seemed genuinely concerned, a little anxious, and shockingly underdressed for the weather. I averted my eyes, causing Nurse So-and-So to snort. At last, one of them pipes up in a nasal, whiny tone that would have been stereotypically applied to a stripper, "Can we see [the patient]?"
"And you are...?" I asked, looking over my computer screen.
"We're her friends. And we work with her. She was at my bachelorette party," says she.
"I'll tell her you're here. What's your name?"
"It's Nikki. With an I." she says, spelling her name and holding out her hand.
"Charmed," I answer, shaking her hand and stiflng the urge to guffaw. I went into Miss Adventure's room and told her she had some friends here, and asked if she would like to have them in- one at a time.
"Oh, pleeeeeeeeze?" She whined.
"Sure." I exit, motion to Nikki-with-an-I, and tell her to go in alone, to speak quietly, and that she has only five minutes.
Well, of course, the moment Nikki-with-an-I enters the room, the Boo-Hoo Fest begins. Miss Adventure escalates, Nikki-with-an-I feeds the fire, and pretty soon they're both bawling and screeching. I removed Nikki-with-an-I. Miss Adventure called me more names. Nikki-with-an-I looked a little shaken.
"Wow, she's really plowed, huh?" says Nikki-with-an-I.
"Like Farmer Brown's back forty," says Nurse So-and-So from behind me.
"How long will she be like this?"
"I dunno. Depends on her. It'll be awhile. Can't really tell you much more than that."
Well, do you think she will be able to work Monday?"
"Well, I don't know. What does she do?"
"Oh, we're both kindergarten teachers."
I have never heard the entire staff of my Emergency Department fall completely silent before. It was as if the breath had been sucked out of our lungs. But Nurse So-and-So, of course, recovered first:
"Thank God I homeschooled."
Wow. Sad.
I have a question, who decides that the patient should be given a urine test? It seems to me that drawing blood should be sufficient to determine her BAC. I ask because I'm ignorant as to the criteria that determines this.
Also, will this be reported to the local law enforcement?
What, no pictures ? ;-)
Wow .. she's a real charmer ... bet her mom is real proud of her .. /sarc >
Holy cow. What a story. Thanks for sharing!
Very well-written, btw.
As far as law enforcement notification goes, the patient really did not break any laws. The bouncers called EMS because the lady got knocked out momentarily. The patient did not drive drunk. And while she tested positive for THC, we cannot inform law enforcement because we did not see her smoking the joint.
Launching all ROFLcopters.
My exact thought.
Great gugly mugly!!! Shoot, if she breathed into the throttle body on my bikes fuel injection system she could have darned near run the thing!
Do not go gentle into that E.R.
Teacher drunk by night, molds our young by day.
Rage, rage against the tying of the straps.
-----
Gotta give props to a kindergarten teacher who can out drink Dylan Thomas.
Nope. If you want a good idea of what the young ladies were wearing, I suppose you could rent one of those Wrestling Divas DVDs. If I ever caught my daughter wearing that kind of stuff, I'd lock her in the basement. And my daughter is in college. (She lives with us, though, and is a pretty good kid, all-in-all. She gets that from her mother, of course!)
Many thanks to you, for performing a thankless task.
I feel for you.
One must never, never underestimate the strength of tiny women especially when they are high on stuff and/or drunk.
God bless you 60Gunner.
I would go nuts if anyone put leather restraints on me.....I'm sort of claustophobic anyway......
I vow here and now to be the worse patient ever when my time comes.....LOL
A .418 and she can recognize her friend Nikki with an i as well as comiserate!
That girl was an underachiever. Her brain was genetically available for much more than being a K teacher.
Which is sad? The fact that she is a saucehead at such an early age, or the fact that she is being paid to teach five-year-olds?
You were too nice to her, taking blood from the inside of her elbow! When I took a header on my 10-speed years ago and cracked my head open, I got an IV on my upper inner thigh, close to the you-know-what, which hurt like all-fired holy hell!
Great story.
Oh, you would not believe the folks we get from time to time. We had a 39 year-old man who with a BAC of 400-plus who also swung, kicked, spat, bit, called us vile names... and live with his mother, who had to come and get him. I felt genuinely sorry for the poor woman. You could see the sorrow in her eyes.
Thanks. I enjoy writing about what I genuinely love doing.
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