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."
VERY interested, and thank you for adding me!
Hmmm.... marihuana may have some anti-nausea effects, but when you're out tying one on I seriously doubt burning a doobie is going to keep you from calling Ralph on the porcelain phone after you reach a certain point. The problem is that you puke and hey! you're ready for more!
Honey, you're halfway there, now just type something in the space. :)
Ahhhhh, the classic "puke and rally". My thinking on this was that since kids of that age often do both at the same time, that there may be a correlation. But I do see what you're saying. That poor girl must have a really exhausted guardian angel up above commercial air space.
One more ticket for your ping list, please...
You tell a nice cautionary tale.
That's not a bad hypothesis.
Gads
Can't HIPPA
sigh,you ED people have all the fun. We don't even get to go down to draw blood on the drunks.......
Yeah? You should see one in a bitter divorce.
What's the phrase? "Removing a man's heart through his wallet"...
so what do i do? become a cop. now we trade stories. thank you for your service. if the bouncers for a club in my precinct made a 911 call for this, one of our units would have responded. this little pain in the butt would have been mased or tased if she spit and swung at me or one of my guys.
I'm sorry to hear that null and void.
No good deed goes unpunished...
Hmmmmmm. Good to know, I'll add that to honey is a good antibacterial wound dressing.
I curious about the consent side of this - what happens if she just calmly says "I refuse consent for all treatment, I want to see a lawyer"
Do you still force treatment and force a catheter?
BTW, you have my full sympathy for what sounds like job for Job - more patience than can be expected of a human.
"A lot of the problems seem to be fueled by decades of Feminist indocrinaztion."
It appears to me that the playbook for the indoctrinization of feminists would have to have been written by a 16 or 17 year old boy. By the time my 8 year old son reaches pueberty I expect that the girls will simply lay themselves at his feet an ask to be subjugated.
"all kinds of pointy, shiny things"
Sounds like a veiled reference to the "endoscope of justice", as a FReeper dubbed it. Probably meant the Mark 1 model that needed a muscular orderly to carry it from the storage area to the ER.
:-)
Seriously?
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