“Technology has become so disruptive!” your veteran charge nurse exclaims. “Every time I have to answer one of these mass emails to our department, our organization loses money. My time is very valuable!” she bemoans. “How am I supposed to concentrate on patient care when my work email account dings every 2 minutes with an ‘Urgent’ message?”
A 54-year-old male is in the ED for a paracentesis because he states he is uninsured and has nowhere else to go. He states his last “tap” was about 4 weeks ago and he is starting to feel short of breath even at rest because of all the fluid. He states these are the same symptoms he always gets and denies any issues that are atypical for him. Just to be sure, you run down a list of pertinent negatives and he politely denies fever, pain, melena, confusion, vomiting, and chest pain.
An 84-year-old woman is brought to the emergency department by ambulance for evaluation of altered mental status and syncope. Per family, the patient had complaints of abdominal pain for two days, tactile fevers, decreased PO intake and one episode of non-bloody, non-bilious vomiting. The patient also fell from her bed to the carpet with loss of consciousness for 10 seconds.
A 22-year-old G4P2 female is brought to the emergency department by her boyfriend for pleuritic right sided lower chest pain that she has had for approximately 18 hours. The pain is in the low anterior right side of the chest and radiates to the scapula and upper abdomen. It has been constant, but is not associated with nausea, vomiting, fever, chills, diarrhea or shortness of breath.
“If you are given a second chance in life, don’t blow it,” you advise
your eager resident. It has been an overwhelmingly busy day in the
department. Interspersed between the motor vehicle collisions, hypoxic
and hypotensive CHF exacerbations, and patients with florid sepsis, your
team is trying to see and help all of the ankle pains, throat pains,
and dysuria that have also walked through the waiting room doors.