Something Small

So......................I had an interesting Sat.

My finally call was a 6:55am.
That's right, 5min. before my shift was done.
CT facial bones on a drunk guy, punched in the face.
Sissy posh kid, wearing loafers.
His skin wasn't even bruised. I've seen worse marks on the daily LOC-old-lady-bumped-head.
His friends were very funny. One was getting a facial lac sewn up when I brought Loafer Boy back to the ER.

LB's friend,whispering drunkenly:"Is he gonna stay OK?"
Me, whispering:"I don't know."
LB's friend, whispering to another friend, sitting in the corner trying to hold his head together with two hands(hangover, anyone?): "He look 'sa real bad, huh? She saysa he gonna not be good. Ouch, right?"
Crazy drunks. Home for Springbreak I suppose.

Lemonsucker Tech was late, so I ended up working 24 hours and 25 min. Lotsa money for me!

Dr. Shrug was working in ER again this week-end.
At 11am: A 74y/o man came in with chest pain radiating into his back. Dr. Shrug ordered a Port CXR. She talked to the Rad., Dr. Pissoff, about it. She calls in Dr.Tightpants and they admitted the pt.
I'm having fun naming everybody!

Anyway, around about 3PM the floor orders a 2view T-spine film for back pain. Ho hum. Boring.
When I get to the pt's room, Dr. Tightpants is telling the pt about a report she just recieved from another hosp.

3 months earlier the pt went to hospital Xxxx and had some tests.
Results: Thoracic aortic aneurysm (TAA)
Treatment: Um, nothing.
The pt. didn't even know what an aneursym was. Dr. Tightpants tried to explain it without totally freaking him out.
"Well, it's a sac, in your chest, full of blood, that bulges and if it ruptures (not that your's is!) it can be fatal. You can die."

This is the part where I jump in.
"Ah, Dr. Tightpants? Are you looking for a TAA?"
"Yes."
"Well, you know a T-spine x-ray won't really show that very well. A CT would show that a lot better."
"Mmmm, maybe, but Mr.CP here has an iodine allergy. Could we do it without contrast?"
"The images would turn out better with contrast, if you wanted to pre-medicate him? or I could do it without contrast. The images won't turn out as nice. It's better to do it with contrast, but..."
"No, I don't want to wait and do pre-medication. Just do it without the dye."
"OK"

Fastforward: CT done. I call the Radiologist, Dr. Pissoff.
"Hi, Dr. Pissoff. This is Katalia from hospital Xxx."
"Hello! Hello! How are you this fine day?"
"Great thank you. I have a CT chest that I just sent over. I don't know if you have the paperwork yet? It's a Mr.CP"
"Well, sure I do, it's right here. For TAA, hmm?"
"Yeah, that's right, um I just wanted to warn you, Dr. Tightpants wanted me to do it without IV contast.."
"ARE YOU KIDDING ME! That just PISSES me off!"
"..so I did it without and the pt has a contrast allergy..."
"I am so PISSED OFF right now! What the hell were you thinking! What the HELL!"
"...and so I did it without contrast."
"So PISSED OFF. GOOD BYE. whatthehell"
He slams the phone down.

It turns out Mr.CP had a ruptured leaking TAA. He was rushed to another hospital for surgery. I hope he is still alive. Only 20 to 30 percent of ruptured TAA pts survive.