"Broke ankle" and Dilaudid

This is probably a topic no one gives a crap about, but I wanna explain why I like my job once in a while. Typically people are not that sick. Sore throats, UTIs (which do suck, but you're probably not going to die), COUGHS, gout, shoulder pain, ant bites: boring.

I personally love it when people are legitimately sick or hurt. Abnormal vitals=right on! (If you're in the medical field, disregard the next few sentences.) Normal vital signs: temperature: 98.6 or less, over 100.4 is considered a real fever; blood pressure: 120/80 is normal, 90/60-low or hypotension, 140/90-high or hypertension; pulse/heart rate: 60-100 beats per minute; Sp02: >90%.

That being said, when taking vitals and you notice that patient's pulse is 160, your mind starts racing. You need to do an EKG ASAP, start a line, you're probably going to give Cardizem and the patient is going to be shipped off to the hospital. It's just a fresh breath of air from all of the mundane crap you see all day and time actually flies. 

Today I brought back a patient who listed his chief complaint as: "broke ankle". A lot of people think they break their ankles, most of the time it's bologna. Not today. This patient's foot was turning purple, the bones looked like they were about to pop through his skin and he was in so much pain he was about to vomit. I gave him 3mg of Dilaudid, and just FYI 10 mg of IV morphine is equivalent to 1.5 mg of IV Dilaudid (hydromorphone). That's according to Wikipedia, don't freak out on me if I am off a little off. 

So, boss man reduced the patient's fracture, which means he pretty much yanked it back into place. Quite gruesome, but I guess after an equivalent to 20mg of morphine you're probably not going to feel too much pain. After reducing it the two doctors held the bones in place while we placed a temporary cast on it ad the patient was transported to FHW for surgery. That hour flew by, seriously, it felt like 5 minutes. Ugh, wish that happened more often.

If you read this entire post, I love you. I was originally going to write about menstruation! Guess that will have to wait until tomorrow. Can't say I did not warn you! :)