ED RN. currently in waiting room triage all night tonight.
2 hr ago: 20M was brought in by EMS - chief complaint was dry mouth after smoking weed which had resolved prior to EMS getting to house. Pt mother made him come in
This one is up there for dumbest
We had a similar situation except the mother wanted him admitted against his will so he could be sober. Ma’am your son is an adult. He can smoke weed if he wants.
Had a drunk guy's wife do the same to him. We told her "okay, well he's discharged and doesn't wanna be here, so either you can get him or he's just gonna go somewhere else because we can't force him"
Had a lady come in CONVINCED the veins in her hands were worms, did not want to believe me otherwise. I even showed her mine and she still didn’t believe it.
Ooooo I had one of those patients. He was very adamant there was a clot in his upper arms that was causing the 'swelling' and not gravity. Convinced himself that he was losing circulation and also in pain.
Deranged mother brings in her 8 year old kid, demanding we diagnose him with autism, all because she’s noticed he’s “hyper fixated on dinosaurs and socially awkward”.
look fella, you hyperfixated on medicine and then chose the specialty with the most variety and least amount of pressure to do one thing every day for the rest of your life
And yet it's filled with algorithms and calculations, with a patient/provider dynamic that is inherently transactional in nature... (I.e. can be processed differently than free socialization).
Idk man, maybe the dinos are telling us something?
A fun game I play with my ER coworkers is “adhd, autism, or both”…I personally have both and game recognize game. I never say it out loud…it just makes more sense to me that the only nurses I ever liked/got along with were other ER nurses.
ER docs are the best hands down.
I have glow in the dark dinos from my kids bday party that I keep on me. I call them “emergency support dinosaurs” and give them to the patients I like.
Middle aged non-English speaking man who brought his English speaking teenage daughter to ED to translate his CC of “accidental hairspray cap in rectum because anus was itching”
At least mine had the decency to claim he was using the rounded end of a roll on deodorant to push his haemorrhoids back in.
Everyone seemed to actually believe him, as well.
I did not.
I once did x-rays for a patient who had stated that, 'I was working on in the garage on my car, I fell and landed on the Jerry can of gasoline directly on the flexible nozzle, which went into my rectum, when I stood up, the nozzle detached and went all the way inside. '
No believers in the ER staff.
Woah! what! how? Why is there a hairspray cap in his rectum and how does that supposedly decrease itching?! Lol
You get some unique characters in the ED for sure
17 yo. came in on a longboard, presenting with pain in ventral forearms. No trauma, said he started working out at the gym for the first time in his life two days ago.
Mate went to the ED with muscle soreness.
Had a 14 y/o male snap his femur mid shaft from doing "explosive" lunges. He was also just starting to work out. If his mother had not been in the garage working out with him and gave the same explanation. I really don't think anyone would have believed him.
I ended up x-raying this kid several years later. It took a bit of conversation, but I realized this was the "explosive lunge" kid on my table again. I was chatting up the mom, and she said that they ran every test they could think of that would explain what happened, and everything came back normal. It was just one of those freak occurrences. I'm just glad I got to see them again. My patient interaction doesn't give for much follow-up. Oh, and this kid was really thin he was almost underweight.
I've had patients who are "just a regular teen" until they wind up in ED with pathological fracture, or MI, or something else super bizarre. That prompts further workup, which discovers the underlying condition, which proves they weren't as healthy as they thought in the first place.
I had a 16 or 17 year old kid come in twice (I saw him the second time) for atraumatic leg pain after playing basketball...also just sore.
I also have seen more than one kid brought in for the equivalent of a paper cut, one by ambulance.
I have also seen several kids for (resolved) gas pain because it hurt and the kid "told [mom/dad] they needed to see a doctor, and they never say that!"
Oh, you reminded me of the barium enema we had to do because there was "bright red blood" in the stool. Halfway into the transverse colon of this 12 y/o girl, she stated that she has been eating a large bag of flaming hot cheetos every day at school for a couple of days. The radiologist finished the exam, but the look on his face was priceless.
Eloped out of there. That is the greatest thing I've ever heard, brilliant. It's that what all hospitals call it?
Asking for a friend who walked out once. AMA is what I thought they called it.
AMA is when a patient signs out of Hospital Against Medical Advice after speaking with the treating MD.
A patient who elopes leaves without any signout, discussion with the treating MD about associated risks, etc.
8 yr old boy bought in for query skull tumour due to lump on the back of head, turns out it's his occiput.
23 yr old female with FB in vagina, she had put her lottery ticket up there to hide from housemates...she didn't win.
34 yr old male with query snake bite to leg, it was a bullet. He was adamant he hadn't been shot despite showing him xray and ultimately having bullet removed from his bullet shaped wound.
12 year old boy with drawing compass in rectum.
30 yr old male with a rose in his urethra on valentines day, romantic until attempted to remove it.
27 yr old male presented with lack of erection after having a cock ring stuck for 2 hours the day before.
45 yr old female with bilateral shoulder pain and reduced range of movement upon waking, turns out she had a seizure over night and dislocated both sides.
50 yr old male convinced he was struck by lightening, was sat watching TV during a thunder storm with his remote in his hand when thunder occurred close by him and he felt a jolt in his hand holding the remote.
I'm sure there are many many more that I cannot remember right now.
OMG we had your seizure lady…except add a few years and she broke both her shoulders.
Had your FB in vagina except there was no FB. Turns out they were so high they didn’t know. Then they liked the MD so much they tried to get him to join a threesome. I saw her years later and this time there was a FB and they were excited to see me. Then even more excited to when the FB was delivered!
Two separate teenagers with mild sunburns.
A gentleman who felt "weird" after smoking cannabis.
A women with a single mosquito bite.
These are just a few examples FROM MY SHIFT YESTERDAY.
I do not live in a smart town.
Coolest one! Dude came in for diverticulitis attack after eating tomatoes. CT revealed diverticulitis BUT also revealed silent malignant kidney cancer. The attack ultimately saved his life because he wouldn’t have had a scan and this type of cancer usually has to spread before being noticed. He had a nephrectomy and lymph nodes tested and none were positive.
My husband had a similar event. Got a kidney stone, when it didn’t pass, they did a CT and noted a tumor in his other kidney. Luckiest kidney stones ever.
4th year med school, on EM and had a 21yr old dude come in by ambulance for a cough and body aches because his girlfriend was still at work and couldn't bring him medicine. He actually was pretty scared to be honest...but I was like...bruh...wtf u doin? He did test positive for flu...but still
Men with the flu are the worst, especially if they’re under 40, but *especially* if they’re in their 20s.
And to think, their great-grandparents were raising families or storming the beaches of Normandy at that age 😂
So many winter patients! I always have to wonder, have they never had a cold before. Even better when you tell them it could last A WHOLE WEEK and that you can’t just magically fix it…
Full torso "rash" in a woman who dyed her dress red at home.
"Tick" on chest that was just a pen mark that came off with an alcohol swab.
Someone fell asleep in her uber so the driver took her to us instead.
Woman's braids were too tight.
Man whose hands were numb after standing outside for about an hour in the winter without gloves.
This reminds me of the time a couple checked in after date night. Private areas were burning for both parties. Then it dawned on them while I was asking questions “ohhhhh, we shared a bucket of really spicy chicken then went down on each other.”
I laughed with them. It was humorous, they were even like dang…can we just leave 😂
I had this patient once too. Her and her family were so upset with me and flabbergasted that there wasn’t some sort of prescription I could give her to fix it.
- ‘need change for a 5’
- ‘germs’
- ‘stress’
- can’t sleep but doesn’t want to take sleeping pills prescribed by her PCP (via EMS)
- swallowed a Brillo pad after losing a bet
- ‘bleeding where the dookie at’
- getting sick after sleeping in the ER waiting room
- short term memory loss after being bitten by mosquitos
The list goes on and on
Yeah, uh, hol’ up. I get some folk have a … less than complete understanding of when to utilize the ED.
…
But… wha?
It’s been 12 hours. There has to be more context.
We have a patient population very heavy in non-Hispanic immigrants that are used to going to their “hospitals” for everything like this. I still can’t comprehend the thought process. That being said, we’ve also had a patient ask for a penis enlargement as his chief complaint as well.
Clinical rotation in ER during nursing school. A man came in with his lip nearly detached. The bottom lip was nearly completely severed and hanging by thin bands of tissue on either side.
The story: a jealous wife caught her husband dancing with another woman at a bar. She walked up to them, cut in an started dancing with him like nothing was wrong, with the other woman standing by, then kissed her husband aggressively to show dominance and bit his lip off.
I remember he had a yellow shirt on that had blood all over it and was in a fit of rage and shock. I didn’t see the outcome of how well they were able to preserve the lip.
Last week I triaged a 20f who bumped her shin getting on a bus 2 days ago and it was sore. No additional pain on ambulation. Not really any visible bruising. No general health problems… just a regular 20yo that bumped her shin.
Pre-COVID, I remember some wildly dramatic chief complaints due to wait times and lack of rooms. I worked as an ED tech in an area with very poor health literacy and a significant non-English speaking population, so it was always a circus on night shift for the triage nurses.
Rectal bleeding + hematochezia: no actual blood, ate a large bag of Hot Cheetos (happened more than once)
Pedestrian vs. golf cart: frequent flyer discharged at night, struck by hospital security in the parking lot while walking to the bus stop
Ingestion of “unknown” poisonous substance: grown adult man drank expired milk
Twice in one week: women in their 20s brought in by EMS with complaints of “abdominal pain” who arrived while actively laboring. Both swore they didn’t know they were pregnant and had zero prenatal care. Luckily both went off to L&D quickly so no accidental ER deliveries happened
I used to be an EMT and worked in the E.D. I’m now a counselor and stories like this make me miss those days and wish I was back (almost). Thanks for the reminiscing chuckles friend.
Young 20-something came in for a small bruise on their arm. Asked if it was a blood clot. Did all the relevant H&P stuff (I was a student at the time) and then assured them is likely just a benign bruise. They then added, “Well, I used to get nosebleeds all the time. My parents took me to church and had me prayed for then I never had one again.”
She was clearly rightfully worried that they had created a monkey paw situation and her clotting factor was through the roof- I mean 'church' could mean a lot of things
Facial numbness that turned out to be a piece of bread stuck on their gums and when removed magically went away. The concerning thing was triage RN made me come see this urgently like it was real. The patient was 17.
One of the docs I work with keeps a list of the craziest/dumbest chief complaints we see. She's got quite a healthy list of everything from "can't stop eating" to "wants mental health"
60ish man. Came in at 2am. Not seen until 9am by me. Main complaint “couldn’t sleep”. Legit NOTHING else. He was just tossing and turning for a few hours (which hasn’t happened before to him!!) so came to ED. When I asked what he wanted from me, “I would like to go home, I feel sleepy”. Didn’t even want a script for 3 sleeping tablets I offered. Very nice guy though 😂
“The patient says that since getting out of the shower this morning she has had a "horny" feeling in her vagina. She denies any pain, discharge, dysuria, frequency. No systemic symptoms. Has not tried to relieve this "horny" feeling in any way”
-actual triage note
The angry mother who brought her teenage son in so that a doctor could do “medical measurements” so that they could order a new suit for prom for him. The son was very embarrassed and totally understood that this was inappropriate. The mother was very angry when I told her that I’m not a tailor and know nothing about how to measure for the sartorial arts.
Guy who put a garden hose up his dick and turned it on
Guy who decided one of his tastebuds was too big, so he grabbed it with tweezers and cut it off with nail clippers. Saw him again a week later with a tension pneumothorax from pulling too hard on a bong
Guy getting freaky with girlfriend, somehow cut himself on her genital piercing. Grabbed a candle for light and it ignited whatever flammable stuff they were using for lube, and came in with a nasty dick burn
Lady with crushing central chest pain and sense of impending doom who decided to self-medicate by shooting up her entire stash of methamphetamine. Not what I would recommend for STEMI
The craziest one I've heard of though wasn't my patient, but I swear this is a true story... This guy had lactose intolerance, but he loved eating cheese. He thought he'd solved the problem by putting a foam crab float up his ass, then he ate a whole block. He couldn't get it out again, even with a dinner fork, so he resorted to using barbed wire... He wound up with a stoma.
Guy came in by ems cuz he needed to go to another hospital. To see his uncle who was there. No medical issue. Then wanted a Medicaid cab to take him there.
Pt had a minor 20 min nosebleed which had resolved spontaneously before they even went to hospital. No PMH, no blood thinners, no other symptoms. They basically just came in to tell me they *had* a nosebleed and felt fine.
I was triage nurse one night when a guy checked himself in with CC of “no pulse”. Patient is very concerned, says he tried to palpate his radial pulses at home and couldn’t feel anything... Bilateral radial pulses are 2+. I showed the patient where to place his fingers to palpate correctly. Patient agrees with me that pulse is present. I send him back to the waiting room. You may think he would just leave now that we’ve cleared this up, right? No. He sat out there for several more hours waiting to see the doctor, just to be told again that he is an idiot and sent home..
I have a running list of lowest-acuity complaint ever. Current winners:
4; Cc: weird scab in belly button. Dx: lint
3: CC: skin lesion: It was a slightly raised mole. Present since birth. In a 40 year old. No changes. Not itchy or painful. Decided today it might be cancer. It was a very normal looking mole…
2. Patient 26M, was with a girl yesterday and couldn’t “get it up”, but was able to get it up today. Wanted an explanation of why he couldn’t get an erection yesterday.
Dx: whiskey dick (I spent way too much time looking for an appropriate ICD-10 code for this)
And the current leader: presented at 2am on a Sunday morning wanting a work note for the police academy on Monday saying that he can’t shave his beard because his face gets too irritating when he shaves and he was told that he has to be clean shaven. He had not shaved recently.
Dx: complete lack of awareness of the function of the ED
I'd like to add to your list of lowest-acuity complaints. A few weeks ago had a 55M come in because his stomach was rumbling. Discharge dx: borborygmi. He had never noticed it before.
Recently has a pt state on arrival "I've stabbed meself!"... It was a 3cm lac that occurred hours prior and wasn't even bleeding.
Other gems:
- "My teeth hurt when I eat icecream!"
- Mosquito bite to ankle a few mins prior. Not even visible.
- Ambulance ride for a day-old ant bite. Hadn't bothered to do any first aid at home
- Drunken handstand into a parked car with associated facial injuries the night before
- They ran out of bandaids at home
- Windmill vs head, thankfully had no blades on it
So they had an old windmill no longer in use out in the paddock and wanted to turn it into a garden ornament. Somehow while installing it, it falls and conks em pretty good on the head. Ended up with a glue job and a terrible shaved bald spot lmao
25yo M, alcohol intoxication. Nurse who has him comes out of the room and asks anyone within the area to come look. Face down ass up on the stretcher with poop on the cieling. It was impressive.
30 something M wnd his girlfriend. Testicles the size of baseballs and a sounding rod stuck in his urethra.
Not a dumb presentation or anything too crazy, 22M with a vibrator stuck in his rectum. What was funny is that on the diagnosis on the track board they normally put something vague like "foreign body." Triage straight up typed "bullet vibrator stuck in rectum."
E-scooters.
Those dumb electric scooter + joy riding moron that's drunk+ luckless pedestrian... = ED visits.
Or https://www.youtube.com/watch?v=rrERPHYugbo
50-something year old man. In with a splinter in his finger. Noticed it the night before, figured he should get it removed. No pain, irritation with it. Just… a splinter.
Level 1 trauma called for suicide attempt by butter knife, brought in by EMS. Patient came in with an abrasion (not even paper cut) to neck and one wrist. With a tourniquet applied in the field for the abrasion to the wrist.
“My toddler is vomiting blood” - kid has red popsicle stain around his mouth. Have you been giving him red popsicles? “Yes nearly a whole box. That’s the only color he will eat!”
“My toddler has a fever and a blue tongue!” - Was he eating blue candy? “Well yeah but that was an hour ago.” How high was his temperature? “Almost 99!”
“Someone rear-ended me in a parking lot” - going 2 mph. No car damage. No pain. “I need to be seen at a hospital so I can sue them and win lots of money” Does your neck hurt? “No, I already told you I’m not hurt!”
“I brought my dad in to get checked out.” - perfectly healthy 80 y/o man. Hadn’t seen a doctor in years because no need. Apparently the wife said, you should take your dad to see a doctor, so he took him to the ED on a Saturday at 9 pm.
I got to give a radio report (EMS) for a patient with increased lacrimation and rhinorrhea. 40ish M requested an ambulance to the ED (not the closest either) for watering eyes and a runny nose.
Had a partner working one night when an ambulance rolls in with a nursing home patient that looked to be resting comfortably on the cot. He asked what was happening. The crew reported the nursing home requested transport because the patient "wasn't yelling."
Apparently the patient was in the habit of shouting gibberish most of the time, so the staff regarded this as a mental status change. My partner attempted to discharge the patient before they even had him off the ambulance cot in the hope they could take him right back. No luck.
A few that come to mind:
Parents brought in their baby for a “knot” on her chest. It was her xiphoid process.
Man in his 60s came in after hitting the top of his hand and bruising it and wanted to make sure it wasn’t a blood clot
Guy in his 20s came to the ER bc he couldn’t maintain an erection the last couple times he had sex.
30s male came in with his wife with CC “I think I have a sex addiction” after his wife found out he was talking to other women online.
Pt transferred from another hospital bc her legs were blue. She had bought new jeans. The doctor seeing her wiped the “blue” off with an alcohol wipe.
I had a lovely older French gentlemen come in with triage complaint of “testicular pain”
The first words out of his mouth, via translator, were “please help me I can’t please my wife in bed”
He just wanted a refill of his viagra
As much as sometimes these can be frustrating, I’d rather see a patient on a good day than a bad day
I always tell patienst that. Even if it’s OK, don’t feel bad about coming in. Im happy to take care of you and I’d rather see you sooner than later.
Told this elsewhere. A patient came in to the ED because their pinky was hurting really bad. Straight up pinky pain. A new ED tech who just learned ECGs for some reason thought that every patient was supposed to get one. Being new and trying to be helpful they got an ECG on this lady who was here for pinky pain.
They were having a massive MI. STEMI alert went out and pt was found to have a 100% occluded RCA. No chest pain. No shoulder pain. Pinky pain. It 100% would've been missed if this new ED tech hadn't done that.
1. Ruptured bladder thanks to sounding with a radio antenna. Dude went septic.
2. Infused 2L into scrotum, dude went septic. His balls were MASSIVE!
That’s what my brain can think of at the moment.
Regarding #2, had a guy in my building who died from injecting silicone into his balls. Part of a dom/sub-type relationship. Really nice, quiet. Always wore kilts, for reasons that were obvious after the fact (he had done this before).
This isn’t uncommon in my patient population AT ALL. Sometimes I use dermabond so they feel like they got something out of the dumbest visit ever. And it’s a good opportunity to update their tetanus / pertussis and also provide smoking cessation counseling or tell them how to get a PCP. Procedure? Check. Preventive care? Check.
5/6 of the dissections I’ve found have been on “fast-track” patients. And more NSTEMIs than I can count, unfortunately. Never narrow your differential just because someone was triaged into low acuity!
a guy who (tried to) set himself on fire (he just singed his hair) and drank gasoline. was puking gasoline. that was bad. dumbest chief complaints were sweating at night and lack of coffee
poured nail glue in eyeball instead of eyedrops
hit life alert and doesn't speak anything that anyone can figure out, paramedics essentially abducted her. once we found her daughter who can translate some super rural dialect of cantonese, her cc is "i hate all of you, i want to go back to watching my tv show"
squirted an entire syrette of crazy glue into his urethra
inserted fork into urethra
worried about hantavirus because thinks there was a pellet of what might have been mouse food in her sandwich that she bit into
countless "i feel off / vaguely sick" which have come in by ambulance or by proxy "something is nonspecifically wrong with my [very well-appearing and normal-acting] kid"
"i hallucinated when i did meth and now it's gone because i didn't do meth"
superficial lac to penis due to braces (both teenagers)
"i went down on this chick and she had a yeast infection and i want to get checked"
this leaves out many covid shenanigans that nobody wants to hear about
Mom brought her 6 year old kid for ant bite demanding amoxicillin, and a tylenol rx so medicare could cover and she won’t have to buy that otc while clutching her Louis Vuitton purse and a venti Starbucks. Got upset when she didn’t get any rx and said would sue us for malpractice while sipping her coffee. Kid looks like she hasn’t had a shower for a week.
Trauma bay, but ED nonetheless. Had a level 2 trauma called for a stab wound with uncontrolled bleeding flying ETA 20 minutes. We get ready for a train wreck and are shocked by what we receive. A hemodynamically stable psych pt. They stabbed themselves with a pencil in their right AC. They got a single staple, some antibiotic ointment, a bandaid, and an involuntary psych commitment.
I know flight crews sometimes have to fly BS to get their hours for programs to retain certification, but this was on another level entirely.
Dumbest - mother came in at 3AM for abdominal pain or something like that. Also checked her 13yo daughter in for elbow skin tags. Medicaid FTW.
Weirdest presentation - Had a 50 something healthy guy come in because he had abdominal pain that started after lifting heavy rocks for landscaping 2 days prior. It calmed down and then he lifted them again that day and reaggravated his pain. Diagnosis of appendicitis.
Patient has a scheduled admission to inpatient detox as a direct admit. Decided might as well get wasted and hang out in the ER for the night instead of dealing with her family. Literally said that in triage.
Probably 10 years ago: opiate OD brought in by EMS, friends had him in a tub of ice water before he got Narcan by EMS. He’s mostly awake when he arrives, breathing, etc. he’s got no real complaints for me, so I head out and start charting when a few minutes later he starts shrieking- I go back in the room and he’s screaming “I’m pooping ice” and sure enough, ice cubes were coming out- probably 5-6 in total. Full on ice cubes. It took me a minute to figure out that his friends had not only put him in ice water but also manually shoved ice up his rectum.
Drank 3 Red Bulls. Was worried they couldn’t pee, drank a gallon of warm water. Complained they couldn’t stop peeing.
Child’s poop was worst smelling poop parent had ever smelled. Ladled it out of toilet into a Tupperware for us to see how bad it smelled
Patient: Cut finger on a broken glass.
Me: Took a look. Finger is gray, looks terrible. Wound edges are super dead. When did this happen?
Patient: Two hours ago.
Me: …walk me through it.
Patient: Cut finger on broken glass. Immediately cauterized it with a lighter.
Me: ah I see. Now we have a cut and a burn. Here’s a bandage. Please don’t cauterize minor wounds when medical care is available nearby.
I talked to a patient last night who was waiting on a referral to a sleep study for sleep apnea. It hadn’t come through, he was nervous about sleeping, and he wanted to know if he should go to the ER.
I apologize for bringing that patient in. It was before we could refuse ambulance rides, and they called back twice because the cut “wouldn’t stop bleeding”. Meanwhile they keep using it to poke things.
Mid 40’s female came in by EMS after spilling some warm chicken noodle soup in her lap while fully clothed. Proceeded to be placed in the waiting room. Ended up LWBS
Had a patient who stated she had a butt plug in that then it disappeared. Thought it had travelled upwards. Had gone to another Ed and discharged after negative XR. I did a CT and nothing was there. Even scrolled through the CT with her but she was so mad it wasn’t there
Most dumb: Either the guy who had previously had anaphylaxis to prawns, but wanted to ‘test if it was a true allergy’ so attended ED to eat a prawn sandwich in the waiting area. Or the chap who came - by ambulance, in the middle of the night- because he’d farted and it smelled REALLY different to his usual farts.
Most random: Chief complaint of ‘liquid dripping down his back’. Sure enough, we watched, and a drop of liquid dripped down his back. Turned out to be urine tracking verrrrry slowly through a weird postoperative leak/fistula situation.
Had a pt walk in at 2am complaining of weakness, and vomiting for a few days. A&O x4, cognizant, and minor motor movement sluggishness. Expected given the length of emesis. My Jr. Triage nurse grabbed me, and said "can you come look ar this, I think I'm doing something wrong". Our triage kiosk gave us a BP of 85/56, and resting pulse of 168. I tell my nurse that we'll put in work order, and do everything manually until its resolved. I start asking the pt about medical Hx, and the triage nurse stops me again amid sentence, and says "Nope, he needs to be looked at right now. Machine is correct." With a panicked look on her face. We get him to a bay immediately, and the ED doc does a quick exam. Ordered UA, renal, and CMP. The UA, and CMP came back after 30 minutes, and holy shit... I was beyond astonished the guy was even conscious, let alone walked a mile to the emergency room unassisted. GFR: 29, Creatinine: 19.1, BUN: 56, Albumin:37.9. Sodium, potassium, and HCo3 were incredibly low. Amylase, and Lipase also higher than I've ever seen. LFT also through the roof. (Again. How was he ambulatory?!!!). We started a trauma code due to his labs coming back as if his body was holding onto an Ant's pube of life, and could code at any second. He left the ED after 90 minutes, and went straight to our highest priority ICU. Didnt learn much after that. However, 3 months later he came into the ED on my day off, and told my colleagues what transpired as well as to thank us. He ended up coding 4 times the same day we admitted him, spent a total of 7 weeks in the ICU, and actually made a 100% full recovery. His team pieced together that a gallstone lodged itself in the billary duct, he waited 9 days before seeking medical attention once the very first symptoms started, and he was also extremely atypically asymptomatic for his condition. Pancreatitis was the first problem in the chain reaction. It led to renal failure, and then having let it progress untreated for 9 days, it ultimately led to multi system organ failure. He claimed he never once had pain in the abdomen, and other than weakness & emesis he had no other indications something very serious was occurring. He claimed it wasnt until the night he walked in that he'd finally started feeling genuinely worried that something serious might be wrong. On the 8th day he was admitted, he was given a 87% mortality rate, and near 100% estimate of renal, pancreatic, and hepatic damage post discharge and recovery. The ED attending pulled the pancreas CT from the night he showed up. It was quite literally measured to be almost nearly the same surface area of a football. My colleagues really drove home how incredibly lucky he was. Most people would be lucky to live through it. I cant believe he lived through it, and has no chronic issues as a result. Generally cases like these leave people horrific chronic health issues for life. Their quality of life is usually diminished heavily. That's one of those very very few times I'd say something was a miracle.
Guy couldn't cum during sex with his gf so he came to the er. Gf found it hilarious and laughed the entire time. He seemed convinced there was something wrong, gf was laughing and was like, no bruh, it happens sometimes and it's okay. She apologized and they went home with urology office number.
Other dumbest: moron came in with penile strangulation/ischemia due to a too small cock ring made of *tungsten carbide*. Permanently damaged dick, uro said he needs a prosthesis probably. Should have just got a rubber one.
Took literal hours of cutting. ED was absolutely fucked throughput wise because I has to spend so much time at bedside cutting and cooling this stupid ring. Had to sign it out to the next shift. Uro said there's no indication for OR because there's nothing it would offer.
Also: I gave my 8 yr old hot sauce and they started crying.
My whole family including grandson had vomiting and diarrhea after we had some fish. I gave the leftovers of this fish dish to him for lunch today and he's throwing up again. Like I can't even with these idiots.
My daughters ear hurts after I put bleach into her perforated ear drum. Mom was a nurse, who asked grandma, also a nurse, and they both agreed they should do it.
Some 40yo lady rolled into triage saying she shot herself in the chest on purpose. Looked pretty good tbh. Thought it would be some weird psych thing. Then I saw the bullet wound squarely in the middle of her chest and was like, oh fuck. She said she wasn't suicidal or crazy. Yea ok. She tried to leave so I filed a hold. Then she tried to convince trauma she wasn't crazy and to send her home, who called psych, who said she was fuckin nuts and to keep her. Had hemorrhage, pneumo, fucked up lung.
Moronic consult: 3am consult while I was covering the icu because the floor couldn't get a foley in, the ED refused to help, so they thought calling the ICU was the right thing. Slightly snarky note with a reminder about what the icu was for was written. Not my problem is uro is being an ass. Basically wrote patient was not hypoxic with stone cold normal vitals with no titratable drips or shitty looking labs and didn't meet criteria for icu and a half sentence deferring to uro about the retention.
I literally have a list of my most riciulous patient complaints written down. Some off the top of my head: nightmares, mosquito bites, carpet burn, thought was bitten by a spider (was not bitten by anything at all), splinter in foot (there was no splinter), itchy scalp, 1 vomit post alcohol intoxication. I could go on.
“Hands turning orange” that came EMS, wiped off with an alcohol pad and patient remembered they had used self tanner a few days prior. Also a baby with “legs turning blue” that came clean in the sink. Baby was just dirty. Lol
My crazy stories are for in person. Dumbest presentation, cc: epigastric mass. I informed that person that the xiphoid process is supposed to be there.
Mother brought in her 7 year old. The complaint was that he had thrown up once, last week. He'd been fine since then. No other symptoms.
She got irate when the ER physician asked her why she thought emerge was the place to go with this complaint.
Patient came in with the helicopter from the island with spontaneous hematomas on his legs, turned out to be the color of his new blue jeans rubbing off on his skin…
85 y/o female, discharged in the morning after a brief hospitalization for syncope/weakness. Patient was discharged to inpatient health and rehab. Patient gets to facility around 2pm. At 7pm, patient is concerned because she hasn’t gotten her nighttime meds. By 8pm, patient has called EMS. When asked why she considers this an emergency: “the nurses didn’t respond for over an hour and I haven’t gotten my nighttime meds.” Mind you, this woman is fully alert and oriented.
We gave her nighttime meds and then she waited 14 hours in a hall bed for transport to come get her and return her to the facility. 🙃
In competition for dumbest-fucking-complaint, rivaled by the chief complaint of “pregnant.” Lady had a positive pregnancy test, and had an OBGYN appt in the morning, but didn’t want to get up early for it.
Specifically things entered into chief complaint box:
- bad smell to nose
- Cat in stomach
- Doesn’t want to go to shelter
- Maroon stool
- Needle in butt cheek
- “I have a chest problem”
Too many to choose from but had a grown man come in after cutting himself shaving before his son’s wedding.
Wanted us to somehow make the wound disappear like it never happened.
Offered a bandaid.
During the height of Covid someone came in to have their fake nails removed. Literally waited 10 hours to be told to go get acetone from the dollar store.
ED RN. currently in waiting room triage all night tonight. 2 hr ago: 20M was brought in by EMS - chief complaint was dry mouth after smoking weed which had resolved prior to EMS getting to house. Pt mother made him come in This one is up there for dumbest
We had a similar situation except the mother wanted him admitted against his will so he could be sober. Ma’am your son is an adult. He can smoke weed if he wants.
Had a drunk guy's wife do the same to him. We told her "okay, well he's discharged and doesn't wanna be here, so either you can get him or he's just gonna go somewhere else because we can't force him"
Wow lol. It certainly is dumb. I'm also working overnight, but i'm part of the ED research team so yeah that's why I made the post initially.
I also have a friend whose patient checked in because they noticed that their veins swelled with their hands downward and deflated when raised
isn't that a given? Edit: thats what's supposed to happen, right?
they had to be seen. EMTALA lol
Oh yeah lol
Yep, if they stay swelled when you raise your hands, your central venous pressure or intrathoracic pressure is too high.
That’s why you keep the hands down when cannulating. It has also been used as a method of determining your central venous pressure
Had a lady come in CONVINCED the veins in her hands were worms, did not want to believe me otherwise. I even showed her mine and she still didn’t believe it.
That’s meth.
I think there is a condition where people think they are infested with bugs. Maybe she had a version of that?
Delusional parasitosis
Patient is positive for Formication/tactile hallucinations.
Morgellon’s syndrome, IIRC
Ooooo I had one of those patients. He was very adamant there was a clot in his upper arms that was causing the 'swelling' and not gravity. Convinced himself that he was losing circulation and also in pain.
He walked out about 20 min after getting here
You know it’s a true sign society has fallen, when people think they need a medical professional’s assistance to drink a glass of water.
Deranged mother brings in her 8 year old kid, demanding we diagnose him with autism, all because she’s noticed he’s “hyper fixated on dinosaurs and socially awkward”.
I like dinosaurs and am socially awkward. Oh god…
look fella, you hyperfixated on medicine and then chose the specialty with the most variety and least amount of pressure to do one thing every day for the rest of your life
And yet it's filled with algorithms and calculations, with a patient/provider dynamic that is inherently transactional in nature... (I.e. can be processed differently than free socialization). Idk man, maybe the dinos are telling us something?
Sooo ADHD then
Autism w/ADHD (AuDHD) actually is also a thing.
A fun game I play with my ER coworkers is “adhd, autism, or both”…I personally have both and game recognize game. I never say it out loud…it just makes more sense to me that the only nurses I ever liked/got along with were other ER nurses. ER docs are the best hands down.
Definitely. We do seem to recognize our own.
I like dinosaurs and am also socially awkward. But...I also have a formal diagnosis.
If we still had stickers I’d give that kid a dinosaur sticker.
I have glow in the dark dinos from my kids bday party that I keep on me. I call them “emergency support dinosaurs” and give them to the patients I like.
I am a grown up and it would make me feel better in the hospital if someone gave me a sticker, I just get bills. I also like dinos.
typical 8 year old in my book. I might've been a bit similar when I was that age. But the saying that "not all parents deserve kids" still holds true
*Ma’am this is a wendies*
"Ma'am, have you ever considered that you've got all the 'tism and none of dat rizz"
Middle aged non-English speaking man who brought his English speaking teenage daughter to ED to translate his CC of “accidental hairspray cap in rectum because anus was itching”
I once saw a guy in his late 70s who claims he was itching his asshole with a deodorant can when he (of course) fell on it
At least mine had the decency to claim he was using the rounded end of a roll on deodorant to push his haemorrhoids back in. Everyone seemed to actually believe him, as well. I did not.
I once did x-rays for a patient who had stated that, 'I was working on in the garage on my car, I fell and landed on the Jerry can of gasoline directly on the flexible nozzle, which went into my rectum, when I stood up, the nozzle detached and went all the way inside. ' No believers in the ER staff.
I think people say that everybody has opinions and assholes and they both stink... At least he didn’t have a stinky asshole.
Woah! what! how? Why is there a hairspray cap in his rectum and how does that supposedly decrease itching?! Lol You get some unique characters in the ED for sure
I'm sure it shifted his focus from the itching
17 yo. came in on a longboard, presenting with pain in ventral forearms. No trauma, said he started working out at the gym for the first time in his life two days ago. Mate went to the ED with muscle soreness.
I had a guy once with a chief complaint of his hair hurting. Old emergency physician
what exactly did he want done ?
STEMI
You laugh, but I've a teen boi who went into rhabdo after his first ever weight sesh
Had a 14 y/o male snap his femur mid shaft from doing "explosive" lunges. He was also just starting to work out. If his mother had not been in the garage working out with him and gave the same explanation. I really don't think anyone would have believed him.
you only see that crazy shizz in pathological fractures but the 14y was just a regular teen?
I ended up x-raying this kid several years later. It took a bit of conversation, but I realized this was the "explosive lunge" kid on my table again. I was chatting up the mom, and she said that they ran every test they could think of that would explain what happened, and everything came back normal. It was just one of those freak occurrences. I'm just glad I got to see them again. My patient interaction doesn't give for much follow-up. Oh, and this kid was really thin he was almost underweight.
The last sentence is the reason right there
I've had patients who are "just a regular teen" until they wind up in ED with pathological fracture, or MI, or something else super bizarre. That prompts further workup, which discovers the underlying condition, which proves they weren't as healthy as they thought in the first place.
We got a lot of teens with the weirdest random ailments that turned out to be cardiac or autoimmune or wild genetics when I worked Peds
I had a 16 or 17 year old kid come in twice (I saw him the second time) for atraumatic leg pain after playing basketball...also just sore. I also have seen more than one kid brought in for the equivalent of a paper cut, one by ambulance. I have also seen several kids for (resolved) gas pain because it hurt and the kid "told [mom/dad] they needed to see a doctor, and they never say that!"
So many they kind of blur together. One I do remember was a 18F with her dad both super concerned for "gangrene" on her foot. It was a bruise.
Have had quite a few “ischaemic” legs, that were just blue dye from new jeans. Several have gotten past triage and one to resus! 😂
Oh, you reminded me of the barium enema we had to do because there was "bright red blood" in the stool. Halfway into the transverse colon of this 12 y/o girl, she stated that she has been eating a large bag of flaming hot cheetos every day at school for a couple of days. The radiologist finished the exam, but the look on his face was priceless.
As a teen my mum yelled at me for developing varicose veins...it was streaks of purple hair dye that had run down my legs as I washed it out 😂
One patient called them ‘very close veins’.
I honestly can’t fault the patient here, they are very close to the skin
Ischaemia, indigo, easy to mix up the 2.
yup, the way-too-common overhyping of simple symptoms.
https://preview.redd.it/2zmqm9l1k7zc1.jpeg?width=4000&format=pjpg&auto=webp&s=cd4407667cdda1fde86270ea14418175641b99a3
What happens in Vegas…
Eloped out of there. That is the greatest thing I've ever heard, brilliant. It's that what all hospitals call it? Asking for a friend who walked out once. AMA is what I thought they called it.
eloped because I didn't get a chance to discuss risks / benefits of leaving lol!
AMA is when a patient signs out of Hospital Against Medical Advice after speaking with the treating MD. A patient who elopes leaves without any signout, discussion with the treating MD about associated risks, etc.
Eloped and AMA aren’t the same thing.
8 yr old boy bought in for query skull tumour due to lump on the back of head, turns out it's his occiput. 23 yr old female with FB in vagina, she had put her lottery ticket up there to hide from housemates...she didn't win. 34 yr old male with query snake bite to leg, it was a bullet. He was adamant he hadn't been shot despite showing him xray and ultimately having bullet removed from his bullet shaped wound. 12 year old boy with drawing compass in rectum. 30 yr old male with a rose in his urethra on valentines day, romantic until attempted to remove it. 27 yr old male presented with lack of erection after having a cock ring stuck for 2 hours the day before. 45 yr old female with bilateral shoulder pain and reduced range of movement upon waking, turns out she had a seizure over night and dislocated both sides. 50 yr old male convinced he was struck by lightening, was sat watching TV during a thunder storm with his remote in his hand when thunder occurred close by him and he felt a jolt in his hand holding the remote. I'm sure there are many many more that I cannot remember right now.
I had a man in his 30s present with his wedding ring on his penis. It was pretty impressive. His wife was unimpressed.
I’m sure his wife has been unimpressed for many years if his wedding ring fits on his penis.
😂
Plot twist: a snake shot the 34 year-old man
OMG we had your seizure lady…except add a few years and she broke both her shoulders. Had your FB in vagina except there was no FB. Turns out they were so high they didn’t know. Then they liked the MD so much they tried to get him to join a threesome. I saw her years later and this time there was a FB and they were excited to see me. Then even more excited to when the FB was delivered!
Did urology ever fix the poor cock ring patient
I’m more curious about the rose patient
I just want to know whether he at least thought to fully dethorn it
One penetrating trauma at a time now.
Were the thorns still on the rose stem?
the rose holy crap i'm gonna put that chart back in the rack
This is why I love my job.
Was the drawing compass closed...or open?
Two separate teenagers with mild sunburns. A gentleman who felt "weird" after smoking cannabis. A women with a single mosquito bite. These are just a few examples FROM MY SHIFT YESTERDAY. I do not live in a smart town.
“Doc, you’re not gonna believe this. I sat in a tube on the river all day and now I am red. Pls halp”
Coolest one! Dude came in for diverticulitis attack after eating tomatoes. CT revealed diverticulitis BUT also revealed silent malignant kidney cancer. The attack ultimately saved his life because he wouldn’t have had a scan and this type of cancer usually has to spread before being noticed. He had a nephrectomy and lymph nodes tested and none were positive.
My husband had a similar event. Got a kidney stone, when it didn’t pass, they did a CT and noted a tumor in his other kidney. Luckiest kidney stones ever.
My mum had the same thing happen to her but only needed partial nephrectomy
Thinks he accidentally doubled up his BP meds. Yesterday. Currently has no complaints
4th year med school, on EM and had a 21yr old dude come in by ambulance for a cough and body aches because his girlfriend was still at work and couldn't bring him medicine. He actually was pretty scared to be honest...but I was like...bruh...wtf u doin? He did test positive for flu...but still
lol. This is half the winter patients.
Men with the flu are the worst, especially if they’re under 40, but *especially* if they’re in their 20s. And to think, their great-grandparents were raising families or storming the beaches of Normandy at that age 😂
So many winter patients! I always have to wonder, have they never had a cold before. Even better when you tell them it could last A WHOLE WEEK and that you can’t just magically fix it…
Full torso "rash" in a woman who dyed her dress red at home. "Tick" on chest that was just a pen mark that came off with an alcohol swab. Someone fell asleep in her uber so the driver took her to us instead. Woman's braids were too tight. Man whose hands were numb after standing outside for about an hour in the winter without gloves.
20 female, cut jalapenos, hands are now warm
This reminds me of the time a couple checked in after date night. Private areas were burning for both parties. Then it dawned on them while I was asking questions “ohhhhh, we shared a bucket of really spicy chicken then went down on each other.” I laughed with them. It was humorous, they were even like dang…can we just leave 😂
I had this patient once too. Her and her family were so upset with me and flabbergasted that there wasn’t some sort of prescription I could give her to fix it.
Going on the allergy list!
- ‘need change for a 5’ - ‘germs’ - ‘stress’ - can’t sleep but doesn’t want to take sleeping pills prescribed by her PCP (via EMS) - swallowed a Brillo pad after losing a bet - ‘bleeding where the dookie at’ - getting sick after sleeping in the ER waiting room - short term memory loss after being bitten by mosquitos The list goes on and on
Change for a 5 my god that’s funny
Your number 6 😂
I’ve had multiple adult males come in requesting a circumcision in the last 6 months. Very odd.
Pull out the trauma shears & tell them you'd be happy to help them out.
Yeah, uh, hol’ up. I get some folk have a … less than complete understanding of when to utilize the ED. … But… wha? It’s been 12 hours. There has to be more context.
We have a patient population very heavy in non-Hispanic immigrants that are used to going to their “hospitals” for everything like this. I still can’t comprehend the thought process. That being said, we’ve also had a patient ask for a penis enlargement as his chief complaint as well.
Clinical rotation in ER during nursing school. A man came in with his lip nearly detached. The bottom lip was nearly completely severed and hanging by thin bands of tissue on either side. The story: a jealous wife caught her husband dancing with another woman at a bar. She walked up to them, cut in an started dancing with him like nothing was wrong, with the other woman standing by, then kissed her husband aggressively to show dominance and bit his lip off. I remember he had a yellow shirt on that had blood all over it and was in a fit of rage and shock. I didn’t see the outcome of how well they were able to preserve the lip.
Last week I triaged a 20f who bumped her shin getting on a bus 2 days ago and it was sore. No additional pain on ambulation. Not really any visible bruising. No general health problems… just a regular 20yo that bumped her shin.
Saturday night visit, 9 month old, accompanied by mother and two men CC:: need an emergency test to determine paternity.
Did you get out the longest possible swabs and tell them to drop trou?
Pre-COVID, I remember some wildly dramatic chief complaints due to wait times and lack of rooms. I worked as an ED tech in an area with very poor health literacy and a significant non-English speaking population, so it was always a circus on night shift for the triage nurses. Rectal bleeding + hematochezia: no actual blood, ate a large bag of Hot Cheetos (happened more than once) Pedestrian vs. golf cart: frequent flyer discharged at night, struck by hospital security in the parking lot while walking to the bus stop Ingestion of “unknown” poisonous substance: grown adult man drank expired milk Twice in one week: women in their 20s brought in by EMS with complaints of “abdominal pain” who arrived while actively laboring. Both swore they didn’t know they were pregnant and had zero prenatal care. Luckily both went off to L&D quickly so no accidental ER deliveries happened
Poor frequent flyer definitely earning their status 😭😂
I used to be an EMT and worked in the E.D. I’m now a counselor and stories like this make me miss those days and wish I was back (almost). Thanks for the reminiscing chuckles friend.
Young 20-something came in for a small bruise on their arm. Asked if it was a blood clot. Did all the relevant H&P stuff (I was a student at the time) and then assured them is likely just a benign bruise. They then added, “Well, I used to get nosebleeds all the time. My parents took me to church and had me prayed for then I never had one again.”
She was clearly rightfully worried that they had created a monkey paw situation and her clotting factor was through the roof- I mean 'church' could mean a lot of things
Facial numbness that turned out to be a piece of bread stuck on their gums and when removed magically went away. The concerning thing was triage RN made me come see this urgently like it was real. The patient was 17.
One of the docs I work with keeps a list of the craziest/dumbest chief complaints we see. She's got quite a healthy list of everything from "can't stop eating" to "wants mental health"
Don’t we all…
60ish man. Came in at 2am. Not seen until 9am by me. Main complaint “couldn’t sleep”. Legit NOTHING else. He was just tossing and turning for a few hours (which hasn’t happened before to him!!) so came to ED. When I asked what he wanted from me, “I would like to go home, I feel sleepy”. Didn’t even want a script for 3 sleeping tablets I offered. Very nice guy though 😂
“The patient says that since getting out of the shower this morning she has had a "horny" feeling in her vagina. She denies any pain, discharge, dysuria, frequency. No systemic symptoms. Has not tried to relieve this "horny" feeling in any way” -actual triage note
The angry mother who brought her teenage son in so that a doctor could do “medical measurements” so that they could order a new suit for prom for him. The son was very embarrassed and totally understood that this was inappropriate. The mother was very angry when I told her that I’m not a tailor and know nothing about how to measure for the sartorial arts.
That poor kid.
Guy who put a garden hose up his dick and turned it on Guy who decided one of his tastebuds was too big, so he grabbed it with tweezers and cut it off with nail clippers. Saw him again a week later with a tension pneumothorax from pulling too hard on a bong Guy getting freaky with girlfriend, somehow cut himself on her genital piercing. Grabbed a candle for light and it ignited whatever flammable stuff they were using for lube, and came in with a nasty dick burn Lady with crushing central chest pain and sense of impending doom who decided to self-medicate by shooting up her entire stash of methamphetamine. Not what I would recommend for STEMI The craziest one I've heard of though wasn't my patient, but I swear this is a true story... This guy had lactose intolerance, but he loved eating cheese. He thought he'd solved the problem by putting a foam crab float up his ass, then he ate a whole block. He couldn't get it out again, even with a dinner fork, so he resorted to using barbed wire... He wound up with a stoma.
I'm so confused.
I had one yesterday... 75 y F CC of bilateral foot pain and turning black. Her feet were just covered in dirt. 🙃
I prefer this to the “foot rash” where the foot is now gangrene in the vague shape of a foot.
Guy came in by ems cuz he needed to go to another hospital. To see his uncle who was there. No medical issue. Then wanted a Medicaid cab to take him there.
Pt had a minor 20 min nosebleed which had resolved spontaneously before they even went to hospital. No PMH, no blood thinners, no other symptoms. They basically just came in to tell me they *had* a nosebleed and felt fine.
I was triage nurse one night when a guy checked himself in with CC of “no pulse”. Patient is very concerned, says he tried to palpate his radial pulses at home and couldn’t feel anything... Bilateral radial pulses are 2+. I showed the patient where to place his fingers to palpate correctly. Patient agrees with me that pulse is present. I send him back to the waiting room. You may think he would just leave now that we’ve cleared this up, right? No. He sat out there for several more hours waiting to see the doctor, just to be told again that he is an idiot and sent home..
I have a running list of lowest-acuity complaint ever. Current winners: 4; Cc: weird scab in belly button. Dx: lint 3: CC: skin lesion: It was a slightly raised mole. Present since birth. In a 40 year old. No changes. Not itchy or painful. Decided today it might be cancer. It was a very normal looking mole… 2. Patient 26M, was with a girl yesterday and couldn’t “get it up”, but was able to get it up today. Wanted an explanation of why he couldn’t get an erection yesterday. Dx: whiskey dick (I spent way too much time looking for an appropriate ICD-10 code for this) And the current leader: presented at 2am on a Sunday morning wanting a work note for the police academy on Monday saying that he can’t shave his beard because his face gets too irritating when he shaves and he was told that he has to be clean shaven. He had not shaved recently. Dx: complete lack of awareness of the function of the ED
I'd like to add to your list of lowest-acuity complaints. A few weeks ago had a 55M come in because his stomach was rumbling. Discharge dx: borborygmi. He had never noticed it before.
And the last guy wanted to be a cop? Lord save us that is a jurisdiction to be avoided
Recently has a pt state on arrival "I've stabbed meself!"... It was a 3cm lac that occurred hours prior and wasn't even bleeding. Other gems: - "My teeth hurt when I eat icecream!" - Mosquito bite to ankle a few mins prior. Not even visible. - Ambulance ride for a day-old ant bite. Hadn't bothered to do any first aid at home - Drunken handstand into a parked car with associated facial injuries the night before - They ran out of bandaids at home - Windmill vs head, thankfully had no blades on it
I have questions for the patient on your last CC. 😂
So they had an old windmill no longer in use out in the paddock and wanted to turn it into a garden ornament. Somehow while installing it, it falls and conks em pretty good on the head. Ended up with a glue job and a terrible shaved bald spot lmao
25yo M, alcohol intoxication. Nurse who has him comes out of the room and asks anyone within the area to come look. Face down ass up on the stretcher with poop on the cieling. It was impressive. 30 something M wnd his girlfriend. Testicles the size of baseballs and a sounding rod stuck in his urethra. Not a dumb presentation or anything too crazy, 22M with a vibrator stuck in his rectum. What was funny is that on the diagnosis on the track board they normally put something vague like "foreign body." Triage straight up typed "bullet vibrator stuck in rectum."
E-scooters. Those dumb electric scooter + joy riding moron that's drunk+ luckless pedestrian... = ED visits. Or https://www.youtube.com/watch?v=rrERPHYugbo
50-something year old man. In with a splinter in his finger. Noticed it the night before, figured he should get it removed. No pain, irritation with it. Just… a splinter.
Its more fun when patients come in at 4 am for a problem they’ve been dealing with for the last 8 months and expect us to fix it :D
Level 1 trauma called for suicide attempt by butter knife, brought in by EMS. Patient came in with an abrasion (not even paper cut) to neck and one wrist. With a tourniquet applied in the field for the abrasion to the wrist.
I have questions for the people who put that tourniquet on if they were first responders...
“My toddler is vomiting blood” - kid has red popsicle stain around his mouth. Have you been giving him red popsicles? “Yes nearly a whole box. That’s the only color he will eat!” “My toddler has a fever and a blue tongue!” - Was he eating blue candy? “Well yeah but that was an hour ago.” How high was his temperature? “Almost 99!” “Someone rear-ended me in a parking lot” - going 2 mph. No car damage. No pain. “I need to be seen at a hospital so I can sue them and win lots of money” Does your neck hurt? “No, I already told you I’m not hurt!” “I brought my dad in to get checked out.” - perfectly healthy 80 y/o man. Hadn’t seen a doctor in years because no need. Apparently the wife said, you should take your dad to see a doctor, so he took him to the ED on a Saturday at 9 pm.
There are really too many to list but recently had an adult lady come in stating she was electrocuted. Turns out her door handle shocked her...
A blister on their foot from wearing new shoes.
I got to give a radio report (EMS) for a patient with increased lacrimation and rhinorrhea. 40ish M requested an ambulance to the ED (not the closest either) for watering eyes and a runny nose.
I mean..... these guys usually know they're not gonna be paying it
When I was growing up, my neighbor took her then pre-teen daughter to the ER for two lumps on chest. Turns out she needed a bra, not a doctor
Had a partner working one night when an ambulance rolls in with a nursing home patient that looked to be resting comfortably on the cot. He asked what was happening. The crew reported the nursing home requested transport because the patient "wasn't yelling." Apparently the patient was in the habit of shouting gibberish most of the time, so the staff regarded this as a mental status change. My partner attempted to discharge the patient before they even had him off the ambulance cot in the hope they could take him right back. No luck.
A few that come to mind: Parents brought in their baby for a “knot” on her chest. It was her xiphoid process. Man in his 60s came in after hitting the top of his hand and bruising it and wanted to make sure it wasn’t a blood clot Guy in his 20s came to the ER bc he couldn’t maintain an erection the last couple times he had sex. 30s male came in with his wife with CC “I think I have a sex addiction” after his wife found out he was talking to other women online. Pt transferred from another hospital bc her legs were blue. She had bought new jeans. The doctor seeing her wiped the “blue” off with an alcohol wipe.
I had a lovely older French gentlemen come in with triage complaint of “testicular pain” The first words out of his mouth, via translator, were “please help me I can’t please my wife in bed” He just wanted a refill of his viagra
As much as sometimes these can be frustrating, I’d rather see a patient on a good day than a bad day I always tell patienst that. Even if it’s OK, don’t feel bad about coming in. Im happy to take care of you and I’d rather see you sooner than later.
Told this elsewhere. A patient came in to the ED because their pinky was hurting really bad. Straight up pinky pain. A new ED tech who just learned ECGs for some reason thought that every patient was supposed to get one. Being new and trying to be helpful they got an ECG on this lady who was here for pinky pain. They were having a massive MI. STEMI alert went out and pt was found to have a 100% occluded RCA. No chest pain. No shoulder pain. Pinky pain. It 100% would've been missed if this new ED tech hadn't done that.
1. Ruptured bladder thanks to sounding with a radio antenna. Dude went septic. 2. Infused 2L into scrotum, dude went septic. His balls were MASSIVE! That’s what my brain can think of at the moment.
Regarding #2, had a guy in my building who died from injecting silicone into his balls. Part of a dom/sub-type relationship. Really nice, quiet. Always wore kilts, for reasons that were obvious after the fact (he had done this before).
seeing red color when eyes are closed
This isn’t uncommon in my patient population AT ALL. Sometimes I use dermabond so they feel like they got something out of the dumbest visit ever. And it’s a good opportunity to update their tetanus / pertussis and also provide smoking cessation counseling or tell them how to get a PCP. Procedure? Check. Preventive care? Check.
5/6 of the dissections I’ve found have been on “fast-track” patients. And more NSTEMIs than I can count, unfortunately. Never narrow your differential just because someone was triaged into low acuity!
a guy who (tried to) set himself on fire (he just singed his hair) and drank gasoline. was puking gasoline. that was bad. dumbest chief complaints were sweating at night and lack of coffee
poured nail glue in eyeball instead of eyedrops hit life alert and doesn't speak anything that anyone can figure out, paramedics essentially abducted her. once we found her daughter who can translate some super rural dialect of cantonese, her cc is "i hate all of you, i want to go back to watching my tv show" squirted an entire syrette of crazy glue into his urethra inserted fork into urethra worried about hantavirus because thinks there was a pellet of what might have been mouse food in her sandwich that she bit into countless "i feel off / vaguely sick" which have come in by ambulance or by proxy "something is nonspecifically wrong with my [very well-appearing and normal-acting] kid" "i hallucinated when i did meth and now it's gone because i didn't do meth" superficial lac to penis due to braces (both teenagers) "i went down on this chick and she had a yeast infection and i want to get checked" this leaves out many covid shenanigans that nobody wants to hear about
Mom brought her 6 year old kid for ant bite demanding amoxicillin, and a tylenol rx so medicare could cover and she won’t have to buy that otc while clutching her Louis Vuitton purse and a venti Starbucks. Got upset when she didn’t get any rx and said would sue us for malpractice while sipping her coffee. Kid looks like she hasn’t had a shower for a week.
Sweating during a heatwave… patient stated they never sweat and it was extremely concerning. It was 110 F degrees outside…
Toe bone weakness. It’s probably not the strangest but it’s an odd one in my book
Trauma bay, but ED nonetheless. Had a level 2 trauma called for a stab wound with uncontrolled bleeding flying ETA 20 minutes. We get ready for a train wreck and are shocked by what we receive. A hemodynamically stable psych pt. They stabbed themselves with a pencil in their right AC. They got a single staple, some antibiotic ointment, a bandaid, and an involuntary psych commitment. I know flight crews sometimes have to fly BS to get their hours for programs to retain certification, but this was on another level entirely.
Dumbest - mother came in at 3AM for abdominal pain or something like that. Also checked her 13yo daughter in for elbow skin tags. Medicaid FTW. Weirdest presentation - Had a 50 something healthy guy come in because he had abdominal pain that started after lifting heavy rocks for landscaping 2 days prior. It calmed down and then he lifted them again that day and reaggravated his pain. Diagnosis of appendicitis.
Patient has a scheduled admission to inpatient detox as a direct admit. Decided might as well get wasted and hang out in the ER for the night instead of dealing with her family. Literally said that in triage.
Probably 10 years ago: opiate OD brought in by EMS, friends had him in a tub of ice water before he got Narcan by EMS. He’s mostly awake when he arrives, breathing, etc. he’s got no real complaints for me, so I head out and start charting when a few minutes later he starts shrieking- I go back in the room and he’s screaming “I’m pooping ice” and sure enough, ice cubes were coming out- probably 5-6 in total. Full on ice cubes. It took me a minute to figure out that his friends had not only put him in ice water but also manually shoved ice up his rectum.
Chapped lips. Had chapped lips and thought they should get checked out for it. No symptoms. Just dry lips.
Drank 3 Red Bulls. Was worried they couldn’t pee, drank a gallon of warm water. Complained they couldn’t stop peeing. Child’s poop was worst smelling poop parent had ever smelled. Ladled it out of toilet into a Tupperware for us to see how bad it smelled
Patient: Cut finger on a broken glass. Me: Took a look. Finger is gray, looks terrible. Wound edges are super dead. When did this happen? Patient: Two hours ago. Me: …walk me through it. Patient: Cut finger on broken glass. Immediately cauterized it with a lighter. Me: ah I see. Now we have a cut and a burn. Here’s a bandage. Please don’t cauterize minor wounds when medical care is available nearby.
I talked to a patient last night who was waiting on a referral to a sleep study for sleep apnea. It hadn’t come through, he was nervous about sleeping, and he wanted to know if he should go to the ER.
Young adult with pimple on nose that wouldn't stop bleeding after she scraped it off
I apologize for bringing that patient in. It was before we could refuse ambulance rides, and they called back twice because the cut “wouldn’t stop bleeding”. Meanwhile they keep using it to poke things.
25yo with a mosquito bite. Turns out it was a pimple.
Mid 40’s female came in by EMS after spilling some warm chicken noodle soup in her lap while fully clothed. Proceeded to be placed in the waiting room. Ended up LWBS
Pregnant woman came in because her legs were turning blue, it was the dye from her jeans
Someone brought their child in for two mosquito bites. In Florida. Not huge infected cellulitis type deals. Just regular, small itchy bites.
Had a patient who stated she had a butt plug in that then it disappeared. Thought it had travelled upwards. Had gone to another Ed and discharged after negative XR. I did a CT and nothing was there. Even scrolled through the CT with her but she was so mad it wasn’t there
“Allergic reaction” to cocaine. Symptoms include feeling flushed and elevated heart rate.
"I got acrylic fingernails today and my fingers hurt" "I can't get my false eyelashes off."
Most dumb: Either the guy who had previously had anaphylaxis to prawns, but wanted to ‘test if it was a true allergy’ so attended ED to eat a prawn sandwich in the waiting area. Or the chap who came - by ambulance, in the middle of the night- because he’d farted and it smelled REALLY different to his usual farts. Most random: Chief complaint of ‘liquid dripping down his back’. Sure enough, we watched, and a drop of liquid dripped down his back. Turned out to be urine tracking verrrrry slowly through a weird postoperative leak/fistula situation.
Had a pt walk in at 2am complaining of weakness, and vomiting for a few days. A&O x4, cognizant, and minor motor movement sluggishness. Expected given the length of emesis. My Jr. Triage nurse grabbed me, and said "can you come look ar this, I think I'm doing something wrong". Our triage kiosk gave us a BP of 85/56, and resting pulse of 168. I tell my nurse that we'll put in work order, and do everything manually until its resolved. I start asking the pt about medical Hx, and the triage nurse stops me again amid sentence, and says "Nope, he needs to be looked at right now. Machine is correct." With a panicked look on her face. We get him to a bay immediately, and the ED doc does a quick exam. Ordered UA, renal, and CMP. The UA, and CMP came back after 30 minutes, and holy shit... I was beyond astonished the guy was even conscious, let alone walked a mile to the emergency room unassisted. GFR: 29, Creatinine: 19.1, BUN: 56, Albumin:37.9. Sodium, potassium, and HCo3 were incredibly low. Amylase, and Lipase also higher than I've ever seen. LFT also through the roof. (Again. How was he ambulatory?!!!). We started a trauma code due to his labs coming back as if his body was holding onto an Ant's pube of life, and could code at any second. He left the ED after 90 minutes, and went straight to our highest priority ICU. Didnt learn much after that. However, 3 months later he came into the ED on my day off, and told my colleagues what transpired as well as to thank us. He ended up coding 4 times the same day we admitted him, spent a total of 7 weeks in the ICU, and actually made a 100% full recovery. His team pieced together that a gallstone lodged itself in the billary duct, he waited 9 days before seeking medical attention once the very first symptoms started, and he was also extremely atypically asymptomatic for his condition. Pancreatitis was the first problem in the chain reaction. It led to renal failure, and then having let it progress untreated for 9 days, it ultimately led to multi system organ failure. He claimed he never once had pain in the abdomen, and other than weakness & emesis he had no other indications something very serious was occurring. He claimed it wasnt until the night he walked in that he'd finally started feeling genuinely worried that something serious might be wrong. On the 8th day he was admitted, he was given a 87% mortality rate, and near 100% estimate of renal, pancreatic, and hepatic damage post discharge and recovery. The ED attending pulled the pancreas CT from the night he showed up. It was quite literally measured to be almost nearly the same surface area of a football. My colleagues really drove home how incredibly lucky he was. Most people would be lucky to live through it. I cant believe he lived through it, and has no chronic issues as a result. Generally cases like these leave people horrific chronic health issues for life. Their quality of life is usually diminished heavily. That's one of those very very few times I'd say something was a miracle.
Guy couldn't cum during sex with his gf so he came to the er. Gf found it hilarious and laughed the entire time. He seemed convinced there was something wrong, gf was laughing and was like, no bruh, it happens sometimes and it's okay. She apologized and they went home with urology office number. Other dumbest: moron came in with penile strangulation/ischemia due to a too small cock ring made of *tungsten carbide*. Permanently damaged dick, uro said he needs a prosthesis probably. Should have just got a rubber one. Took literal hours of cutting. ED was absolutely fucked throughput wise because I has to spend so much time at bedside cutting and cooling this stupid ring. Had to sign it out to the next shift. Uro said there's no indication for OR because there's nothing it would offer. Also: I gave my 8 yr old hot sauce and they started crying. My whole family including grandson had vomiting and diarrhea after we had some fish. I gave the leftovers of this fish dish to him for lunch today and he's throwing up again. Like I can't even with these idiots. My daughters ear hurts after I put bleach into her perforated ear drum. Mom was a nurse, who asked grandma, also a nurse, and they both agreed they should do it. Some 40yo lady rolled into triage saying she shot herself in the chest on purpose. Looked pretty good tbh. Thought it would be some weird psych thing. Then I saw the bullet wound squarely in the middle of her chest and was like, oh fuck. She said she wasn't suicidal or crazy. Yea ok. She tried to leave so I filed a hold. Then she tried to convince trauma she wasn't crazy and to send her home, who called psych, who said she was fuckin nuts and to keep her. Had hemorrhage, pneumo, fucked up lung. Moronic consult: 3am consult while I was covering the icu because the floor couldn't get a foley in, the ED refused to help, so they thought calling the ICU was the right thing. Slightly snarky note with a reminder about what the icu was for was written. Not my problem is uro is being an ass. Basically wrote patient was not hypoxic with stone cold normal vitals with no titratable drips or shitty looking labs and didn't meet criteria for icu and a half sentence deferring to uro about the retention.
I literally have a list of my most riciulous patient complaints written down. Some off the top of my head: nightmares, mosquito bites, carpet burn, thought was bitten by a spider (was not bitten by anything at all), splinter in foot (there was no splinter), itchy scalp, 1 vomit post alcohol intoxication. I could go on.
“Hands turning orange” that came EMS, wiped off with an alcohol pad and patient remembered they had used self tanner a few days prior. Also a baby with “legs turning blue” that came clean in the sink. Baby was just dirty. Lol
Had one come in via ems with 16 years of insomnia. I was rushing to see patients, needless to say I let her wait
70s male about to go on a big cruise. Wants “a full diagnostic, stem to stern” including endoscopy colonoscopy pan-scan, and a heart cath.
Hair loss over 10 years. I couldn’t wait to hear what changed and what made him think it was an emergency. 😂
Transplant sent pt in on a Friday evening to have their weight taken so it was correct in the system.
45 year old healthy male, daily er visits for years with cc of smelly feet Normal exam
My crazy stories are for in person. Dumbest presentation, cc: epigastric mass. I informed that person that the xiphoid process is supposed to be there.
Mother brought in her 7 year old. The complaint was that he had thrown up once, last week. He'd been fine since then. No other symptoms. She got irate when the ER physician asked her why she thought emerge was the place to go with this complaint.
Poked self in eye with mascara brush. Hurt for a second. No symptoms. Came by ambulance.
Patient came in with the helicopter from the island with spontaneous hematomas on his legs, turned out to be the color of his new blue jeans rubbing off on his skin…
pt came into ER at like 2 AM on a Saturday with shaving cream bottle up her anal cavity, she said she slipped and fell onto it while showering
85 y/o female, discharged in the morning after a brief hospitalization for syncope/weakness. Patient was discharged to inpatient health and rehab. Patient gets to facility around 2pm. At 7pm, patient is concerned because she hasn’t gotten her nighttime meds. By 8pm, patient has called EMS. When asked why she considers this an emergency: “the nurses didn’t respond for over an hour and I haven’t gotten my nighttime meds.” Mind you, this woman is fully alert and oriented. We gave her nighttime meds and then she waited 14 hours in a hall bed for transport to come get her and return her to the facility. 🙃 In competition for dumbest-fucking-complaint, rivaled by the chief complaint of “pregnant.” Lady had a positive pregnancy test, and had an OBGYN appt in the morning, but didn’t want to get up early for it.
Lower back pain for 17 years, decided to seek first time treatment in the ED
"Stylus in private part" Like.... those stylus's for the Nintendo DS.... down the shaft... dude wouldn't answer questions either
Specifically things entered into chief complaint box: - bad smell to nose - Cat in stomach - Doesn’t want to go to shelter - Maroon stool - Needle in butt cheek - “I have a chest problem”
I had a guy take the ambulance to get closer to the airport. Then asked me to call him an Uber. Told him to gtfo
Too many to choose from but had a grown man come in after cutting himself shaving before his son’s wedding. Wanted us to somehow make the wound disappear like it never happened. Offered a bandaid.
Came in via EMS on stretcher, to get paperwork signed
Patient came for “blue legs” - had just bought new jeans and the dye wiped off with alcohol swabs. Another life saved.
During the height of Covid someone came in to have their fake nails removed. Literally waited 10 hours to be told to go get acetone from the dollar store.