The HOLY SHIT Sign

Will the stories ever finish in this place.  Hope not, gives me plenty to write about!

There are some jobs where you can mess up, forget to do something, and well end of the day you wasted time / money or a bit of both.  Replenish-able stuff.

Dont think you can “replenish” your DAD if I forget to do something, mess up while doing something, or something happens when im doing something to him!  Dont think you’d be too happy either.

A guy came to the ED at 10:45pm, tummy pain and vomiting.  Generally, we tend to XRAY / ECG the majority of patients who make it through the offices to the observation units.  Especially with a presentation such as that, because tummy pain can mean either

-Tummy pain

or

-Heart pain

What a waste of medical terminology.  “heart pain and tummy pain” .. Sigh, anyway

Which is why we do a quick Heart, Lung and Abdomen examination.  Then we follow that with xrays and ecgs to further investigate the patient.

Tummy pain in most cases would be covered with an xray, and heart pain well an ECG would cover it a lot of the time.

So this old baba, fresh in at 10:45pm was passed by the ED doctor (im talking about the guys who travelled from far and beyond to ply their trade here to make money and remain 40 years outdated in medicine) to the cardiologist (heart doctor) who insisted this issue wasnt a cardiac problem.

So then, when you dont know who to pass it onto, you can always call the medics because they’ll take about anything.  So, he was passed onto a medical physician at 9:30am the next day.  You following me so far?

The medical physician ordered a chest xray because, well, poor guy didnt have one.

The chest xray was seen at 2pm before I went home at the end of my MORNING shift.

This is what we saw

Holy Shit

Now lets forget that the guy has a heart half the size of his entire chest, thats ok cuz its not an “acute” thing to deal with.

Whats a bloody SURGICAL EMERGENCY is what we call “air under the diaphragm”, thats the space between that “white line” I marked and the white stuff underneath.  Thats AIR, and its not meant to be there.  Its usually hard to spot because the amount of air is small barely visible under the diaphragm.  In that photo, its umm.. well quite clear!

The air usually means some organ inside perforated and gas is escaping into an area it shouldnt.  In short, patients DIE from this, young or old and need to be taken to the operating theatre ASAP.

This dude was gassing up from 10:45pm the day before and is LUCKY to be even alive the next afternoon!!

All this could have been avoided if that dumbass just felt his stomach or xrayed his chest.

But hey-ho is the way some people work.. 9-5 pm job eh?

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