Saturday, February 22, 2014

Molly, molly, molly get your adverbs here!

Looks like we have another of Darwin's herd culling drugs.  Sooner or later the IV drug shooters die of ODs and endocarditis, the crack addicts die of MIs and stokes and the meth heads fry their brains.  All of which serve to self limit the epidemic.  Molly seems to be doing the same thing.  These users show up hypermetabolic in renal failure and seizing,  permanent brain damage occurs and they end up in a SNF where they slowly die of aspiration and bedsores.

Here are molly's adverbs : stupidly, hastily, fatally, painfully, hopelessly, violently and permanently

Unsolicited Medical Advice

I cant imagine being a pharmacist!  It must be horribly boring and tedious and I am so grateful when they catch a stupid mistake I made regarding a dose, allergy or interaction.  They drive me nuts though when they starting suggesting other medical treatments.  One of my patients recently had a script filled for flagyl.  The pharmacist asked her what it was for, and the patient replied that it was for some problems she had "down below".  The pharmacist then suggested several vaginal douches and also recommended that the patient be tested for other STDS.  The patient was horrified that she might have something else and called the office upset.  We had to explain that the flagyl indeed for her antibiotic induced diarrhea and not for the vaginal issue the pharmacist was discussing!

Code Brown Boomerang!

All to often a patient from the ICU will have to go to the OR for a procedure.  These patients are usually on vents with lines everywhere.  A code brown will happen, usually right before they have to go to the OR.  Our basic rule is if it happens on your watch, you take care of it.  So if it happens in the ICU, the ICU team cleans it up. If it happens in the OR, the OR team takes care of it.  There are some who try to hide it in the ICU because it is hard to move the patient and they think "well the OR team will have to move them to the OR table, so it will be easier for them to clean it!" but this doesn't happen to much.  The real problem, is what happens during transport.  One patient had a bad blow out in the ICU and they cleaned it, in the OR they were clean and they were clean when they went back on the ICU bed.  When they got back to the ICU, there it was again.  the blow out happened right between the OR and the ICU.  The ICU nurse got all mad and demanded the OR team come back and clean it up.  There was a huge discussion on the rules of code browns and "he who smelt it must deal with it", but when it was all over both teams took care of the patient, who had another code brown a few minutes later.