We had a steady stream of work today. One of the cases that affected me most was a 22 year old coming in, 17 weeks' pregnant and spotting. We'd actually had a patient earlier in the morning come in who was in the middle of miscarrying. She had hoped the baby might be saved, but ultrasound showed she'd already lost it.
My patient basically broke her waters around midnight last night. When I put the ultrasound probe on her, I could see very little fetal movement even though the heart was still beating. We did a pelvic (yes, ick, that's right), and we found that her cervix was at 1cm open. She got admitted and will probably be passing the fetus some time tonight. She was very sad.
Otherwise, a mishmosh of this and that, mostly things that can be taken care of in a primary physician's office, but when your doctor has a full schedule and can't get you in today, you come to the E.D. Or, when you don't like the care your doctor gave you, you come to the E.D. for a quick fix, even though it's something your primary care doctor should have taken care of.
My patients today...
Back pain man - I've had chronic back pain for year then fell at work a week ago and my doctor gave me pain meds but they're not helping and I want you to make me better.
Tattoo man - I don't care what kind of bet you make with your buddies when you're 20, when they ask you to tattoo women's clothing on your body and you do it, there's something just wrong there. (I would have loved to have taken a photo, but a surgery resident just lost their job for photographing a patient's privates that were specially tattooed, on a bet mind you.)
Seizure lady - softball-size brain tumor removed 17 years ago and as a consequence has seizures. Found in her car in the parking lot of a store after she ran over a curb and came to a stop.
PROM (premature rupture of membranes) girl - the one I mentioned before. Admitted to OB/gyn.
Rule out MI lady - sent in from her doctor's office after complaining of being dizzy and having been found to have low blood pressure. Her complaint to us was of chest pain, so we had to admit her to evaluate for an MI (heart attack.) Very nice lady; she's had 11 children. Ouch.
Pneumonia lady - Another patient sent from their doctor's office for a lowO2 saturation (82%). She had pneumonia and was being admitted.
Sore throat lady - just got that tickle feeling in the back of the throat and wanted to get it checked out. Cultures sent and she was sent out the door.
No pedi's today (pedi's = children, as in pediatrics).
Back to work over the weekend. We'll see what's stirring up!