Monday, July 17, 2006

Triage Tales 22

Disclaimer: The following story is a work of fiction. All similarities to people, places, things and events are coincidental by nature.
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34 year old female shows up with multiple sutured wounds.

She figured in a nasty argument with her husband, who stabbed her multiple times on the right anterior chest wall, left hand, and left shoulder. One week ago.

Initially seen in a local hospital one week ago (Mandaluyong City Medical Center), a chest tube was inserted on the right side for "hemothorax". At least, that was the history we gleamed from the 1/4 sheet of paper that was supposed to be a referral note.

"Non-resolution of dyspnea prompted patient to seek transfer of hospital."

Patient was dyspneic, cannot tolerate supine, and had decreased to absent breath sounds on the right lung field. She also had a nasty cough, which she said began only two days ago.

And so the relatives bring the patient to our institution, not knowing that the surgical resident would have to work with this lack of information.

On chest Xray there was a suspicious level on the right lung field; but the Xray doesnt't tell us if it is fluid or an organized abscess. Worst case scenario, they open up the patient and try to resolve the "hemothorax".

To admit that you are not capable of further care for this patient is one thing. To "dump" said patient in a busy ER, adding to the worried of already overworked surgical residents... that is just plain mean.

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