Shiloh County Medical Center - Emergency Department

[A. Breslin]

*I arrive at the hospital in the command car. Smith hasnt said much. I drive into the bay. *

'Come on.'

*We walk into the ER and I walk up to the registration clerk.*

'County employee, line of duty injury, Its going to be a comp case. Gonna need a blood draw and the cocktail.'

*The clerk briefly looks up seemingly annoyed at us being there.*

'Name, Date of birth address and chief complaint.'

*I look at smith.*

'Give her your information, Employee health will call you in the morning.'

*I leave Smith in the ER still annoyed at the paperwork that I will have to do over this easily preventable injury.*

[A. Smith]

“Alysaa Smith 7/22/1996 live at apartments 18 cook street”

*id hate being here it smells well I’m most likely losing my job*

[Dr. J. Thompson]

*I look up as I see the EMS duty officer storm in with what looks like a young trainee. She talks angrily to the registration nurse for a few moments before leaving. The trainee didn't appear to have anything wrong with her. I look back to the computer as a nurse takes the trainee to a room, and I scan for a new name assigned to that room. Finding it, I open her chart and take a quick glance. Worker's Comp..spit on..unknown pathology in the assaulter. Great. Drug cocktail and PEP in her future, for sure. I assign myself to the room and stand up, walking over. I knock on the door to respect her privacy before walking in anyways to assert my dominance. After all, this is my ER room.*

'Good afternoon, I'm Dr. Thompson. Can you tell me what happened?'

[A. Smith]

*he look likes a doctor from the movies. I need some wine and cheese*

’hi i was I was at a accident scene and when I shine a light into the person eye he spit at me and call me a bitch’

[Dr. J. Thompson]

'Yeah, turns out people don't like it when you shine flashlights in their eyes. Do you have any allergies? Any medical history?'

*I cross my arms, looking down at the girl. A nurse comes in, starting to take her vital signs.*

[A. Smith]

‘Not really I had head surgery when I was 12 but that about it and I have no allergies’

*i remember I was riding my bike and a car hit I woke up 24 hours later I see my mom crying and that about all I remembered*

[B.R. Jackson]

*after a somewhat relaxed drive into the city i pull medic 5 into the ambulance bay marking ourr status acordingly as i hop out and head to the back doors opening it and then proceed to help doug and the parient outta the truck as she was walking* 'you use anything,ill go grab what we needa restock while you transfer care?

Edited May 19, 2020 by Vanguard

[D.McGuire]

*We arrive at the hospital; I’ve completed most of the chart and also obtained a second set of vitals during transport. Also used some sterile water and some gauze pads to clean up the patients face a bit. I disconnect her from the monitor and help her stand up and out of the truck along with Bobby when he asks about restocking anything*

’Just some sterile water and a 4x4 gauze pad. Thanks’

*I walk up to the charge nurse who glances at the patient then back to me. Before she can ask I tell her the story*
 

’Lacerations to her head from glass. Driver in a car vs. cow accident. No other complaints, vitals normal’

’Triage.’

*She replies, seemingly without thought. She probably had that word on the tip of her tongue as soon as she saw the patient coming in on foot rather than stretcher or wheelchair. I walk with the patient to the triage area. I direct her to have a seat, she does so*
 

’I’m going to go up and get you checked in. They’ll call your name or come to you, alright? Take care, feel better’

*She thanks me and I turn and go to the currently unoccupied triage desk, nurse must’ve stepped away. I pull out my phone to answer some texts as I stand at the triage desk awaiting the return of a nurse or doctor or whoever*

[B.R. Jackson]

* i nod and while doug checks the patient in i move to resupply the trucck litle as it may be,getting what doug said aswell as a few other odds and ends i hadent had a chance to restock  that were low this morning that done i head back over to doug* ' good to roll when your done  all  restocked, think the lieutenants still here what you think is up with the rookie?'

[Dr. J. Thompson]

'I see. Better hope the blood test on that patient comes back clean, or you might have to add AIDS or hepatitis or something to that list.'

*I turn and leave the room, walking down towards the ambulance entrance. Just before I went in, I had heard the radio report from the medic coming in with the patient from that car wreck. Seeing the ambulance outside, I glance at the board to make sure they weren't given a room before heading out to triage. I spot the medic and walk up to him.*

'Hey there, I'm Doctor Thompson. You bring in the cowtastrophe?'

[D.McGuire]

*Out of the corner of my eye I notice somebody approaching, appears to be a doctor. I lock my phone and slide it into my pocket then open up the charting computer to the patient demographics page*

'Doctor Thompson, hi - Doug McGuire. Yes, this is the result of the, uh, cowtastrophe.' I say with a chuckle, 'Female, 26, restrained driver in the car vs. steer accident at residential area speed. Lacerations to the head from broken glass, still some glass in her hair, no active bleeding. No LOC, no other complaints, vitals normal, transport uneventful, and no change in patient condition throughout contact. No allergies, no history, takes birth control.'

*As I rattle off my report believing to have covered just about everything, I work my way through the chart pages to the last 'Receiving Signature' page and pull then stylus out waiting to see if the doctor is interested in signing or will have me continue to wait for the triage nurse to sign*

[Dr. J. Thompson]

*I listen to the report and nod when he's done.*

'This is the spitter?'

*I scrawl my John Thompson across the tablet, passing him back the pen.*

'J.D. Thompson,' *I tell him, knowing he needed my full name for the ePCR.*

'Tell you about any bloodborne diseases? Or deny all of it?'

[D.McGuire]

*I nod as he asks if this is the spitter*
 

’This is the spitter’

 

*I reply as I hand him the pen, he signs the tablet then hands it back to me stating his name; I type it in*
 

’Thank you sir... Uncooperative answering that on scene, was pretty pissed with the EMT that received the spit. Would not confirm or deny.”

[Dr. J. Thompson]

*I nod again.*

'Right. We'll figure it out, one way or another. Thanks Doug.'

*I step back into the triage area, logging into a computer and starting to log orders.*

[Dr. C. Grant]

*I walk into the computer bank where the off-going attending is seated, presumably finishing a chart. He's an older man, someone who's been here for a long time.*

'What's going on Kevin?' I ask him as I put my stuff down at the computer spot next to him.

'Chris. How'd you get stuck with the 11p to 11am shift?' he asks.

'Trade. My daughter's got this father-daughter day thing on a day I was already scheduled for.' I say. 'It's not like trading a 6a to 6p shift for an 11p to 11a shift is hard.'

'Fair enough. Good thing you aren't neglecting your family like I did.' he says typing away on the keyboard.

'I didn't think you had kids.' I reply perplexed.

'I didn't...and that's why.' he says.

'Fair enough' I reply back in kind.

'Listen I got just one to hand off to you. 24 year old female with 5 days of abdominal pain, nausea, and vomiting. Lipase was through the roof, ultrasound negative, pregnancy negative. He's being admitted by Dr. Faruq but we're still waiting on him to come down and see him. On fluids, got PO potassium, zofran, and some morphine. Pretty low maintenance.' 

'Wow. Just one? What an evening, huh?' I say in surprise.

He logs out of his computer and gets up from his seat.

'I hope the same for you.' he says as he starts to pack his stuff up.

'Much appreciated,' I say logging into the computer.

'Oh, and one last thing. St. Gardena's is sending over a transfer. Sedated and intubated. Diagnosis is....well....look at the chart.' he says with a smile.

'Lets's just say whenever Dr. Bae wants to transfer someone I don't refuse. I consider it a public service to get people out of his ER.' he replies as he starts walking away.

Oh God...Dr. Bae? What did this one do? Urinate on his car?

I look at the chart for the transfer. My jaw drops.

-------------------------------------------------

Diagnosis: 👹

Plan of care: Transfer to SCMC for higher level of care by ALS amberlamps 🤘

Reason for transfer: 💗🧡💛💚💙💜

--------------------------------------------------

Did he....did he use emoji's in his documentation??? How does this guy still have a license?

I look around and see Thompson.

'Hey Dr. Thompson, for your educational benefit, want to see how not to write a transfer document?' I say as I beckon him over. 

Edited May 27, 2020 by Chris07

[Steve Bae]

I call the hospital.

 

"HEY BROS! JUST CALLIN TO SEE HOW MY DUDES DOIN! THANKS FOR TAKING HIM HOMIES!" Is what I try to say as I'm eating a donut. I finally swallow it after the operator says she can't understand me for the tenth time.

I wash it down with some fresh, delicious grumbo coffee, this delicious flavor is called Wazorp. Bought it on line from some dude who said he's a scientist. It's pretty lit. Anyways.

 

"Heyyyyy, I need to talk to my bro Chris Grant. If you could just put him on."

[Steve Bae]

We finally arrive in our behemoth of a rig. Its funny. I just talked to Grant on the phone and had to hang up because of this. 

 

We come in, I go ahead and tell them what i have 

 

""Hey, unknown age male unresponsive with multiple arrests post traffic collision  we have a pressure of 90/42, satting 92% on a vent, pulse 144 with pvcs, bilateral chest tubes, txa on board, central line established and a bloody mess of bandages and tourniquets, billateral leg amputation and a lot of fractures, we don't have the equipment for that." 

I follow the team into the room.

[Dr. J. Thompson]

'Hey Dr. Thompson, for your educational benefit, want to see how not to write a transfer document?'

*I look up from the desk I was sitting up and then stand, walking over to Dr. Grant.*

'St. Gardena sending one out?'

*I guess. I had already heard stories of the eccentric Dr. Bae. He seemed like a uh, very interesting individual. I look at the transfer documentation, visibly wincing.*

'Are...are those emojis? In the documentation?'

[D.McGuire]

*We arrive at the hospital after an uneventful transport. I get a repeat set of vitals off the monitor as we pull onto the property which show no remarkable change from the first set; patient’s status is unchanged overall. The three us get the patient out and roll her into the ER and up to the charge nurse; I give her a quick report so she can get us a room*

‘Hi there, 16 year old female fall from a tree. Probably right leg break, loss of pulse motor and sensory to that leg.’

*I say as the charge nurse returns to her computer to find us a room as we await further instruction or for a nurse or doctor to come out to get a better report for Smith to give*

[Dr. J. Thompson]

*I hear EMS come rolling in, and hear the charge nurse direct them to Trauma 4. I walk into the room as the PA system announces the Level III trauma in the ER now. A couple nurses bustle into the trauma room ahead of me as I start pulling gloves on, looking expectantly at EMS as they walk in and waiting for a report.*

[A. Smith]

*id see the doctor time to give my report*

”female her name is Stephanie 16 fell out of tree while climbing I check the femur their no blood flow she definitely bleeding internally very slow  and when I ask what her pain 1-10 she said 10 no medications or allergies and we check her vitals it is 94/67 also her mom is coming very soon“

*i know how she feels I fell off a tree on once was in a cast for two months*

 

Edited June 11, 2020 by Aidan721

[Dr. J. Thompson]

*I nod slowly.*

'OK...no IV access, Doug? Any pain meds?'

*One of the trauma nurses starts hooking her up to the monitor as another begins looking for IV access. I wasn't thrilled that it appeared that EMS hadn't done much for this patient. She definitely warranted some pain control in my opinion.*

[D.McGuire]

*As ED staff begins doing their thing I listen over Smith’s report to Dr. Thompson as I started cleaning up the monitor when he asks about IV and Pain Meds*

’She came from the park a few blocks down so I opted for rapid transport here over anything on scene’

*I think to myself I probably could’ve made more of an effort to at the very least get IV access for them during the short transport but 🤷🏻‍♂️*

[Dr. J. Thompson]

*I nod.*

'Understandable.'

*I sign off on the EMS chart and glance over to nurses as they secure an 18 in her AC and get a set of vitals run.*

'Alright, let's go ahead and give her 100mcg of Fentanyl, and let's get X-Ray in here to have a look at that leg. While X-Ray is getting set up, let's Doppler the foot and make sure we've got no pulses.'

[E. Sjostrom]

*Arriving at the bay I back M1 up so the back is facing the door in.  Coming to a stop I shut of the sirens and put the truck in park.  Flipping off the lights I exit the driver's seat and rush around to the back where I help open the back doors.*