Friday, October 14, 2005

Triage Time

Angry Doctor posts a story about a houseman not being able to turf a case to another department.

Reminds me of my time at Triage not so long ago.

Elderly male comes to ER with non-healing wound on his right sole. Wound smelled like hell when I removed the cloth wrap. A known diabetic, he alleges to have been religiously taking his medicine. Stat blood sugar is high normal, with patient having no other complaints, so I ask my senior if I can send patient to Orthopedics.

Ortho intern: (After glancing at the still-wrapped foot) DM foot yan, di ba dapat IM muna? (That's a diabetic foot, don't you think you should have referred the patient to Medicine?)

Me: Normal CBG. Di naman mukhang DKA eh. Puede nyo bang tingnan muna? (It doesn't seem like he's in acidosis. Could you assess him first?)

Ortho intern: Hay naku, dapat tinurf nyo na yan agad papuntang OPD, maaga pa naman. Wala din naman kaming gagawin diyan eh. (You should have sent him to the OPD yourselves, it's still early. We can't do anything to him here.)

Me: Di mo na hihintayin residente mo? (Won't you wait for your senior?)

Ortho intern: Hindi na, papuntahin mo na sa OPD. (No, just send him to the OPD.)

After conferring with my senior, we talked to the patient and sent him to the OPD instead. On hindsight, I should have made a more convincing case, but as a Triage intern I can't impose on my fellow interns. My senior made the call to send him to the OPD.

I hope that wasn't osteomyelitis.

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