And first, some levity

A friend reminded me that there are some hunkered experiences had by those of us wading in the nasty side of life ~ Emergency Room Medicine. I'll share a few of the rules I have learned for surviving a trip the the ER.

There are tropes and stereotypes from the various TV shows, I'll just skip right by those. Don't go there.

Things you can do to impress the staff....

• Nothing is more enlightening than explaining to someone that "X" only kills people on TV.
• Or, when people explain to me that this wasn't how they did it on Trauma Life in the ER... That is a sure way to demonstrate your knowledge to the friendly ER staff, quote an entertainment show as a standard of care.
• Also, if you googled something, please keep that information to yourself. Your google-fu may be strong but it makes you look coached, "I am having a deep peritonitis-like pain around McBurney's point." Does not sound like an appendicitis to me it sound like a crazy person... just say, "Do you think this could be an appendicitis."
• Last but not least, that fact that your brother in law is a doctor does not transmit the information via osmosis through a marriage certificate.

Things you should avoid doing in the ER

• Eat from the vending machine while complaining of belly pain or vomiting.
• Check in more than one person with the comment "while we were here we figured you could look at..."
• Utter the following statement to your doctor or nurse, "My doctors office opens in an hour but I really needed to be at .... [insert movie, work, date]"
• Utter the following to your doctor or nurse, "I need to be out of here in .... [insert an hour, 2 hours, or a week]"
• Cuss in some language other then English... give it to me strait up.
• Try to leave the ER while drunk, high, suicidal, or after you have hit your head.
• Taking a dump on the bed because your headache was sooo bad that you could not sit on a bedside commode.
• Tell anyone, "Help me I'm having a seizure."
• Talk on the cell phone when anyone is present (unless you are calling for a ride home or telling significant others that you are going to emergency surgery).
• Have more then a handful of allergies (and all of those allergies to pain killers)
• Have the staff greet you by name when you walk in the door or say "What brings you in TODAY Frank."
• Tell the triage nurse, "I'm having Chest Pain" and then tell your doctor or nurse - "I didn't want to wait out there with all the sick people. I know I said chest pain but I have this terrible back pain."
• Say, "Ish din'tt has anisting to drunk or du ani druggz" Trust me, we will figure it out. Just own up.

Things that result in uncomfortable experiences in the ER (other than the fact that you are in the frakkin ER)

• Spitting on the staff. Result = some lingering jaw pain for a few days (from fingers wedged into your cheek to keep you from spitting). If you have a known communicable disease you may wind up in jail.
• Hitting or Kicking Staff. Result = most likely you will be hog tied to the bed after your are submitted by folks who understand exactly how far your arm can bend without breaking.
• Include "I'll kill everyone in this place" in any sentence. Result = bad juju.
• Intimidate or threaten that cute little 23 year old baby nurse taking care of you. Result = the rest of us find her just as adorably innocent as you did. We treasure innocence.
• Try to wrestle or box me while bleeding, drunk, and naked... in the hall. Trust me, you really don't want to do this one.
• This one is X-rated so I'll leave it to your imagination.

What NOT to bring to the ER

• The snake that bit you. Really. I don't need to see it. You don't think I need to see the gun that shot you, so why would I need the snake that bit you? Leave the snake outside the ER!!! We got slow people in wheel chairs and walkers. Watching them freak out and try to run when the escaped snake comes slithering around is the nightmare of othro doctors everywhere. The snake is a bowling ball for broken hips - It just depends on how many pins you started with.
• Your gun. Hey, I love guns as much as the next person and own a few myself. A gun in the ER says, "Hey, Look at me. I'm Tim McVeigh." That is never a good thing in the ER. Never.
• The whole graduating class of 2007. If you are under 20 and injured in a car accident or some other freak of nature event. Do not call your friends while strapped to the backboard telling them, "Call everyone. I think I am dying." I know that you have little experience with pain and trauma but trust me if you want to call - you are not dying. Having your 85 "best friends" crying and wailing in the lobby won't help. In fact, they probably blocked the sight of that 58 year old man who could not breath from the triage nurse. Thanks, once you all clear out someone will tell us there is a dead person in the lobby - some 58 year old dude.
• Razors... I know you like to cut on your freaky little arms and that is why you are here. But, I got to search your pockets to make sure you don't "ad lib" while in our care. Mostly I just make you strip and cut all the pockets out of your clothes so that I can see into them. Reaching into the pockets of strangers in the ER is like that horror movie when the cute 19 year old coed reaches into that dark hole for the thing she dropped. You just know she is going to have her arm eaten off.
• Your body fluids in a wal-mart sack. I know you think I want to see that neon colored gelatinous vomit that has cooked in the wal-mart sack for 3 hours. It isn't going to help me in the least. I never looked at vomit or crap in a bag and yelled, "I need epi, stat!"

Up next time.... anecdotes and things that might have happened somewhere but you can't know. Sometimes funny, sometimes tragic, delivered with the not-so-deft touch of yours truly [I got a bad case of bull-in-the-china-shop syndrome]. Also, tell-tale signs that your nurse is a moron.

*Try not to take this thread personally. If I took everything said to me in the ER personally, I'd have blown out the ol brain pan years ago.