Not Every Case is a Trauma
Friday, June 01, 2007
Anil Menon, MD
It is 5:25 AM, Kaiser Emergency Department, and to my surprise I have time to write this blog. That means that all of our patients have been discharged--for a moment at least. This also illustrates that not everyone that comes through the door is a trauma. I thought it might be interesting to write a blog about a seemingly non-intense case to paint a more realistic picture of the emergency department. At least temporarily. It is just like the World Series of Poker that I always get caught up watching. Only the exciting hands make it to our television screen but the actual game is made in all the hands that are thrown away without any fanfare.
This case was an easy one for me. And, sometimes I look forward to those easy ones during a busy day. I think we all do.
Blood pressure rises with stress and anxiety. A one-time reading above baseline is nothing to get worked up about, and getting worked up about it just makes it go even higher. We only treat elevated blood pressure when it is also associated with other clinical problems such as stroke or vision changes. That usually doesn't result from one high reading. In fact Franklin Roosevelt was known to be travelling around the country with a blood pressure consistently above 250/150. There are long term consequences to this that require lifestyle changes and medical management but nothing we will do in the ED. The hard part was making the woman calmer. Her blood pressure did go down to 130/90. Now that's an effective treatment.
4 Comments:
At Fri Jun 08, 09:42:00 PM 2007,
Anonymous said…
Interesting.
At Thu Jun 28, 12:36:00 PM 2007,
Tina said…
I've seen alot of times when I was at the emergency , the nurse are almost falling asleep, and other nights they got so busy they had get nurses off the main floors, lately I got told not to come ack this i for emer, not for pimpels, at the time I had a temp of 104.5, and still climing, I've got about 4 absces, on left,5 on the right,and now I've got one on my ankel, in a scare on my stomack, more showing up daily, I had a very bright red line on my spine ,now I can't even walk, and I told them the one has this very bright red line going up my spine, I told them, and just because my bodgy dosen't heal well, and can only use 1 antiboitic ,they have to give that by I.V, and gravol so I'm not getting sick all the time,I thought it was ileagal for them to ture you away , there's so much infection running through my sistyem, temp,103 today, I can't get help, and I don't have the strangth to fight it this time, I'm doing everything I can
At Wed Jul 11, 03:20:00 PM 2007,
Anil said…
Tina. I'm not sure where you live but there are laws that require emergency departments to see anyone who presents to their door with a complaint. EMTALA (see www.emtala.com) actually originated in California with the help of one our faculty Dr. Bressler. An important law for sure.
At Thu May 22, 08:50:00 PM 2008,
Anonymous said…
Is there any possiblity that you have a borderline personality disorder that is very treatable with psych meds?
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