Bizarre Emergency Cases 2006

Not what you were expecting.....

• A trauma case involving a very macho, jean clad male with workboots. He had been drinking at a rough bar and had been pushed down a flight of stairs. He suffered a head injury and presented with decreased level of consciousness. As his clothes were cut off a pair of woman's pantyhose was revealed followed by frilly underwear and bright pink toenails.

• An MVC trauma case involving a stunningly beautiful woman. Bloodwork had been drawn. She was still alert and oriented and requested that her underwear not be removed as we cut off her clothing. However, a nurse noticed safety pins on her underwear so they were cut off in preparation for a CT scan. The pins had been securing the underwear in place to hold and conceal her penis and testicles posteriorly. She had almost fooled the entire trauma team into believing she was a woman, and we had almost requested a stat pregnancy test on a man.

• A trauma case involving a male sex-trade worker gone horribly wrong. A very large and buff man presented as a severe assault case. He was naked accept for a red silk and chain thong and large handcuffs. In this case a pair of bolt cutters from the engineering department turned out to be the most useful trauma tool.

Some patients will try the darndest things......

• A known cocaine user presented complaining of chest pain and requesting narcotics. After a normal ECG and bloodwork he was not satisfied with having received only ASA for chest pain. Instead, in order to receive ATIVAN IV, he appeared to have a full body seizure. He was putting on a good show...eyes rolled back, drooling, full body convulsing. However, the nurse was not convinced and grabbed his hand and yelled, "If you are having a seizure squeeze my hand to let me know." The patient squeezed her hand extra hard to let her know how extra legitimate he was. All the staff laughed and he was told "no Ativan, no narcotics for you". He got up and left. (Note: In a true tonic-clonic seizure the patient loses all control over his conscious actions.)

• EMS crew had notified us that they were on route with a status epilepticus. Staff were waiting at the door. However, upon arrival, the patient was well known to St. Michael's ER. and the physician called out to him to "stop fooling around or I will take away your driver's license". The EMS crew were amazed to see their "convulsing" patient yell, "No one is going to fucking take away my license" and get off the stretcher and walk out the door.

• A man presented to ER in police custody. The police explained that he had been arrested on a minor charge and was being held in jail when he confessed to a much larger crime of smuggling 2 Gm cocaine. At first I was confused, and asked why would a man be confessing to such a serious crime. The police explained that the man had been trying to smuggle drugs into the prison system by swallowing cocaine-filled condoms. He would then enter the prison system on a minor charge and excrete the condoms and sell it to his inside co-horts. In theory, the man would then be released 2 Gm lighter and much richer. Unfortunately, the patient had realized that one of the condoms had broke and he was now being treated for cocaine ovedose and a much larger criminal offense.

• A long term inmate of the Toronto prison will occasionally counteract the boredom of jail time by swallowing objects such as eyeglasses, cutlery etc... This allows him time out for a gastroscopy under sedation, a good post-op meal and best of all, he can sneek a peek at females. I have seen him two times so far this year.

Hope for our youth....

I find it discouraging that on a weekly basis we receive teenagers completely wasted on drugs and alcohol. It is even more discouraging to see parents either indifferent or over-coddling about the state of their child. But one mom stands out in my mind. Her daughter had been brought in by friends after a night of clubbing and alcohol use. She was unresponsive to painful stimulus, incontinent of urine and had vomit all over her. Her mother was very concerned about the girl's state of health and was even more concerned about helping her to avoid future occurrences. So, she whipped out her camera and took pictures of her daughter lying on the stretcher with an intravenous, an naso-tracheal tube in nose (to protect her airway), diapers (for incontinency), vomit in her hair and drool running down her chin. She said that she would blow up the picture and use it as an educational tool to teach her daughter, and her other children, about the dangers of excessive alcohol use. Very cool...