It happened twice in a recent shift, but there’s no name for it.
Patients decide to go to the hospital. Usually they’re feeling weak.
They get into the car and get driven to the hospital (if patients drive themselves to the hospital, by definition this syndrome cannot occur)
By the time the patient reaches the hospital, they are too weak to get out of the car.
The person driving them must then park the car (usually in an area that blocks ambulances), come into the hospital, and request that someone come out to the car with a wheelchair to get the patient into the hospital. During the drive to the hospital, some patients become so weak that they need to be lifted or dragged out of the car.
Then an amazing thing occurs.
Once inside the hospital, a significant majority of the patients will stand up to get undressed. Some even walk to the bathroom.
I was going to call this syndrome AWWTED – Acute Weakness When Taken to the Emergency Department, but I opted for a more “medical” sounding syndrome:
I’m calling it ATATPA – Acute Transient Accompanied Transloculatory Paralytic Attacks.
They are paralytic attacks that happen suddenly, go away quickly, and only occur when the patient is driven to the ED.
Now if we could only find a medication to treat this at home …
also known as “unstable chronic fatigue syndrome,” “malignant fibromyalgia,” and “supratentorial pansynaptopenia” to quote an old article from the canadian journal of emergency medicine
I had to dig a little, but found the article:
http://www.caep.ca/template.asp?id=856C87FBD94B4B00AD1967C6274AEA6F
Thanks!
oh.. sorry for the lack of link. it’s a pretty fantastic article though, don’t you think?
i call it the ISOTCOYM syndrome…in layman’s terms, I’m sick of taking care of your mother who guilted you into promising never to put her into a nursing home. more common among the frail gult tripping elderly female population. It is usually also presents with middle-aged momma’s boy or guilt ridden daughter. Outcome is usually poor for staff.
Very interesting. The physical effects of mental anguish are facinating to me. So would it be safe to categorize these as ‘panic attacks’?
Maybe they just want a ride in a wheelchair. Weeee!
Aren’t you aware of the dramatic increase in gravity around entrances to emergency departments? This is probably just a side effect of EMTALA and fades away under 2 circumstances. The hospital accepts the patient for treatment. The patient is transported outside of the 250 yard EMTALA Zone.
If there is a bar, convenience store, mall, or house of ill repute within the EMTALA Zone it fades away once the vehicle enters a parking space for the facility with magical healing powers. If the hospital would hire the shamans from these facilities, Press Ganey would rate that hospital highest in the country. These shamans travel undercover. they use titles that mislead – bar tender, sales clerk, barista, hair dresser, drug dealer, . . . .
you need to give up that conventional medical schtick and move on to greener pastures – and I do mean greener. No messing with the FDA or Medicare. No student loans. No responsibility.
is it wrong that i’m suddenly having visions of building a catapult with a 250-ft range?
The increasing gravity well has been well described as the EMTALA-Schwartzchild radius. The Schwartzchild radius is the radius around a black hole where where neither light nor particles can escape the gravity.
An interesting concept, yet to be explained, is how ambulances determine my hospital becomes the closest facility to every point IN THE UNIVERSE. This phenomena is time dependent, occurring more frequently after midnight. And it has an interesting associated phenomena of “level fade”… where a 3pm level I trauma becomes a 3am level II trauma.
Snicker
Now THIS is the old WhiteCoat that we all know & love… keep ‘em coming, WC…..
…’ride in a wheelchair’….heh!
Awhile ago, I wrote about a similar problem, probably a variant on the AWWTED spectrum—the patient that acutely loses ability to perform ADLs in the direct presence of a nurse. Walking, voiding, and getting dressed are all lost acutely. Sometimes weakness occurs after the car parks outside of the ER, sometimes it occurs acutely when brought back to an actual room. More research is needed to distinguish between the two. Why do some patients only lose the ability to walk, why are others unable to pee on a toilet and require a bedpan when they just did in the lobby?
nurse k, in my observation, the inability to perform tasks seems to be in an inverse ratio to the proximity of family member also….the closer the family member the more debilitating the symptoms. when family member leaves independence can spontaneously return. tis a mystery.
I have witnessed many ATATPA patients presenting to the ED. No doubt.. it is perplexing.
Then last June, I became an unwilling member of said ATATPA patient group.
But I am of a variant patient population…those that arrive via medical transport.
Anyone working around emergency dept or other medical field would agree… that they would do *anything and everything* possible to AVOID being transported to the ED via ambulance.
*Think of the Weird Al Yankovic song “One More Minute” http://www.youtube.com/watch?v=SKBKbj54hy4
Substitute your own equivalent of “I’d rather spend eternity eating shards of broken glass”,for what medical workers *would rather do* than arrive via ambulance as a patient for the ED.
*Quadruple that if you work for said ED. Am I right?
Fortunately, I didn’t work there, but I knew I was going to HAVE to go to ED, but waited too long and then I became so unexpectedly and instantly weak..that I thought I might die and so *I* called 911.(How HUMILIATING)I honestly didn’t think it was safe for my husband to drive me.
Arrived inside ED smiling and friendly. Whatever it was passed when I got into ED and was told to go wait in waiting room. (Now I realize I had succumbed to ATATPA. Who knew?)
DOUBLE HUMILIATING because now I was one of *THOSE* patients! I’ll bet my face was magenta.
I really was S-O-O-O-O EMABARRASSED and only had tunnel vision for the 5 mile l-o-o-o-n-g walk out to the waiting room with the other *ambulatory* patients!
I waited a long time because they were busy. I was later vindicated with a diagnosis of pre-sepsis among other things.
Yet WC… I magically transformed from the *I think I might die patient* to *Happy Miss Sunshine patient*, and so I propose to you that it has to do with the EMF waves at the point of entry via the electronic doors into the ED… and that patients predisposed… will succumb to this syndrome.
Also known as the “Dying Swan” syndrome. Amazingly they also get up when the dinner trays come around…..
Dying swan syndrome? THAT’S funny ERP!