Happy Granny Dump Days!
I also was approached by the professional practice council from the ER about teaching a critical care class down there as well! Its weird how stuff works out. I don't mind teaching, but I'm always nervous that someone is going to ask a question that I don't know the answer to.
The ER leading up to Turkey Day was absolute insanity. The Monday-Wednesday are officially referred to as "Granny Dump Day." Thats when families come up with a good story about why grandma needs to be admitted to the hospital over the holiday. Usually they drop off Monday or Tuesday and are "unable" to pick her up on Wednesday or Thursday morning. Its sad, but predictable.
Had a transfer head bleed (from coumadin and htn) that has an INR of over 7, no ffp of Vit K given. She had no exam on arrival and we were in the process of prepping her for brain death testing. When the neurosurgeon went to tell the family (all 40 some of them) they started screaming, yelling, throwing up, throwing themselves on the floor... someone went AFTER the doc and got arrested. It was quite the scene. The poor chaplain said its the worst reaction she has seen in 15 years. At least they were OUTSIDE of the ER and couldn't get back to where I was.
I also had a lady who weighed 450lbs and was short of breath (surprise, surprise). She was too big for the bedside commode and would have crushed the bedpan. I tried to take her to the handicap bathroom and help her to the toilet. Let me refresh.... I am 5'0 and not a big person.... she was about 5'3 and 450lbs. This was not an even match up. Had she gone down I would have had to just get outta the way! When we finally got back and the MD ordered Lasix that was my limit. I recruited some (very good) friends to put in a foley. It took three of us and I was in the bed with the patient. I can tell that there is still some ICU left in me.... I had to clean her up down there before I would put the foley in. It was just the right thing to do.... even if the right thing smells like it hasn't seen warm water and soap in several weeks.
My (former) base manager left for Afghanistan yesterday. He is going to be a medic embedded with the Afghan army. Please keep him in your prayers... I am so worried about him.