Friday, September 21, 2007

The Red Bag Sign...

So, last night was drug and alcohol night, and the majority of the patients followed the adage of the Coneheads and "consumed mass quantities."  I was told that most of the local bars run specials on Thursday night and that the local college crowd gets a little rowdy. 

I was also introduced to a new medical diagnostic clue:  the Red Bag sign.  That's when a patient is so drunk or high they're vomiting, so the EMS guys tie a red bag around their neck like a bib so the patient can vomit right into it and not mess up the nice clean ambulance.  You pretty much know the diagnosis and the management as the patient is being wheeled in the door; red bag flopping, or sloshing, just a little as the case may be.

So, while one half of our patients were partying it up and getting rowdy (crashing cars, breaking windows, falling down stairs, knocking on neighbors doors and demanding to be let in to the point of being arrested and brought in by Buffalo PD, etc.) the other half of our patients were depressed and suicidal leading to a mixed bag of drug and alcohol combinations that were each a case study on how to treat overdoses.  Some were just drug A.  Some were drug A + alcohol.  Some were drug A + B.  And several were drugs A - F swallowed down with a good slug of vodka, or beer.  Of course, if you're going to really try to make a statement, you might just be a murder suspect being chased by police through the woods and decide to stab yourself several times in the neck with a hunting knife.  That'll show 'em.

And, speaking of cutting, I did have an 18 year old with cutting scars on her feet:  one of which read, "I love you to DEATH"  Seriously.  Cut into the top of her feet.  When I first went in to examine her, I thought she'd had some sort of accident.  Then I noticed the scar lines seemed to be making some kind of pattern, which I soon understood to be words.  Then I actually got to the point I could read the words.  This on a girl who didn't want any blood work done because needles scared her.  Uh, honey, you let someone CARVE into your skin with something most likely bigger and sharper than a needle.  Hmmm...

As of the time I left, all of the overdose patients were still alive (some despite repeated attempts at offing themselves with drug cocktails), the drunks were detoxing (we usually just let them sleep it off, sometimes needing four point restraints for those that refuse to go to sleep peacefully), the crack and cocaine abusers who were developing paranoid delusions as the night went on were being sent to the psych side, and the drunken 18 year old was being picked up to be taken home by her parents with a stern warning by one of the other ED docs about the dangers of alcohol.

Red Bag Thursday night.  The other must-see event.

Oh yeah, by the way, if you once burned the back of your throat while smoking crack cocaine to the extent that you needed to have a hole cut in your neck so that you could breathe, when you come back in complaining of a sore throat after you, uh, yes, wait for it, smoked crack cocaine again, we're gonna laugh at you.  Really.  Laugh and point.  Mhmm.  

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