Home Emergency Medicine Patient in ED Knows Nothing About Medical History, Surgeries, or Medications

Patient in ED Knows Nothing About Medical History, Surgeries, or Medications

Gomerblog Team
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116
Patient in ED Knows Nothing About Medical History, Surgeries, or Medications

SAN JOSE, CA – When Dr. Anderson, a seasoned emergency room attending, went into room 14 late last night, he experienced a first in his long distinguished medical career.  While getting a history and physical, it occurred to Dr. Anderson that the patient knew next to nothing about his health.

emergency department
“hmm, patient knows…well nothing at all..please see EHR for record”

“I’ve never had a patient before that didn’t know a thing about their medical history, I was dumbfounded and confused.  Not only did he not know which medications he was on and their doses, but had no idea which surgery he has had and when they were.  He didn’t even know his allergies!”

Patient Ralph Brown, 48 years old, of Milwaukee, Wisconsin, had been having abdominal pain that was progressing for roughly 30 days “give or take a month” per the patient.  When interviewed, Mr. Brown reports, “Well, I figured that 1 AM on a Sunday morning was the best time to come in, seeing as it’s been going on for a little while.  I’m far too busy during the week and the 9-5 hours doesn’t fit with my schedule.  I didn’t want to bother my primary care physician, whom I haven’t seen in 15 years, with something like this.  During the week I have poker night and bingo night, so this seemed like the best time.  The ER is the logical place to go for a problem that has been going on for a long time.”

Reports of these so-called “know nothing” patients have been popping up across the country, although they are still very few and far between.  “We had a presentation of this type of patient at the last conference, but I never thought in my life I would get to see one, almost like a malignant hyperthermia case for anesthesiologists.  Some people laughed at the presenter, called him a sensationalist and an exaggerator.  Boy, was he right.”

With plans to write up this surprisingly-odd patient in a case report in the works, Dr. Anderson sent a resident and a medical student into the room to see if they could glean any more information about this enigma.

After leaving room 14 so flabbergasted and astounded that someone could know so little about their health, Dr. Anderson checked into the triage desk for a chest pain rule out. With positive troponins, he went straight to the cath lab, and after 2 stents is expected to be ok.

116 COMMENTS

  3. Happened during my medical school years:
    Pt: “No i don’t have any medical history or meds”
    Me: “were you ever in hospital before? ”
    Pt: “yes”
    Me: “what was it for? ”
    Pt: “oh 2 heart attacks and a stroke”
    Me: ‘(…i need coffee, chocolate and LOTS of it!!!!)’

  6. Once dealt with a diabetic pt with chronic CHF who came in with SOB sans his med list and meds. His excuse for no med list? “I’m on vacation. Why would I need to carry that around on vacation?” And his excuse for not at least bringing his pill bottles or his Dr. contact info? “Look, I’m on vacation. Why would I bring all that stuff on vacation?” Apparently when you’re on vacation your need for emergency medical attention, including the need to reconcile meds after admission, goes on vacation too.

  13. No wonder ambulance crews and triage nurses were always surprised when i would hand over a sheet with copies of my mom’s insurance cards, ID, medications and medical history.

  15. Shelly Soukup, that’s my allergic reaction to reglan! I flipped out! Unfortunately I was on a backboard in the ed under spinal precautions. Not a good time to learn I was allergic to that!

  21. Julie Anne, I think it’s wonderful that you are young and not jaded. All of these people commenting were once like you. I remember being taught decades ago that “pain is whatever the person experiencing it says it is”. In many cases that is true, but unfortunately many people abuse that. No one is going to deny grandma with her broken hip, or a cancer patient or a trauma patient , or someone with a surgical issue. Unfortunately there are people who come in several times a week with vague complaints who have been CTd MRId ultra sounded and had dozens of work ups with no diagnosable pathology who demand narcotics. They hospital hop and get prescriptions from multiple providers. Many are manipulative demanding and in your face. It’s different in the inpatient world. These people are admitted because they are truly ill. I still give people the benefit of the doubt, as I’d rather make the mistake of medicating someone who didn’t truly need it than to leave someone to suffer in pain. Sadly, there are a lot of drug seekers out there who have made us jaded .

  24. Another pet peave is the old lady fall down and break hip thingy….the hip is broken, the patient gets it fixed but the lady appears to be going in and out of afib after surgery. No one has checked to see if the lady is impacted which may have been triggering bouts of arrhithmias which may have been making the old lady dizzy causing her to fall. The lady doesn’t think to tell the doc (or is embarrassed to tell) and the doc never asks and no one ever checks the anus. I only find out when I’m turning the patient affter surgery and see stool protruding or a very obvious anal ring bulge! One order of for dis-impaction and quite often the arrhythmias cease! The patient feels better and her vitals stabilize! So you young Interns reading this…please retain the practise of a complete hands on exam including the “bung hole”! A presurgical disimpaction may save an old lady from a trip to the ICU because they didn’t know that a rectal impaction, irritating the vagal nerve, was throwing the old lady into afib!

  25. We see that a lot…until you tell the drug seeking patient they were here in December with the same pain and they suddenlyy start remembering little bits and pieces until the whole history become complte by the end of your 12 hour shift. Some folks may not tell the whole history because they want the doctor to do a complete “right from scratch” exam. The fear is that if the whole history is known, it will effect, via the doctors’ pre-biases how the doctor will diagnose them.(oh hx of alcohol…put them on CIWA, only it may really be a life threatening issue that the busy doctor will overlook because…well that person was a drunk)

  27. But is it coincidence that CHF and COPD are the two most common reasons for hospital admissions in Canada and the US? At least us lazy ER docs aren’t saying “admit for sarcoidosis vs serotonin syndrome”.

  29. Difficult to tell if this is an act. Malingering is very difficult to prove, but would wonder about secondary gain here. Could be total global amnesia, although this usually affects short term memory primarily and resolves without problems. Finally, could this be delerium

  40. Uuh hello? Every patient in el paso…. sir what meds do you take? “Ohh well i take a little blue one, a red one, oh i am not diabetic… i used to be a long time ago but i take insulin and it went away”. Haha

  56. Haha.. Witness ED fanboys do what they do best: make wrongful judgements based on limited profile views. Personal attacks aside, not a single word uttered in defense of their sub-par practice of medicine. How does it feel to know that you know jussst enough to establish dispo (and not much else?). Hate me all you want; you know I’m right.

  58. well, that’s cuz he’s in the wrong place, see. He SHOULD be in the E.R. I remember watching that show on tv – E.R. I never watched the ED show…..maybe that’s why he’s confused.

  62. Ah yes, just the guy I want on the other end of the phone when I’m 100 miles from the nearest cath lab and Lifeflight’s grounded for weather. Is everybody from Montreal as big a dick as you seem to be, or are you a special case?

  66. I”m sure you will make lots of friends in your career as a cardiologist, but then you will fit right in making $450,000 a year doing nothing but procedures on patients you never actually meet conscious. Enjoy your Maserati dirtbag.

  70. Carly Phelps If you spent time in the ER and heard the way docs feel and talk about and treat patients this would hit a different note with you. They treat these patients differently. For instance 50% of these posts are about drug seekers. ER docs are so jaded by them that they treat people who come in with any complaint about pain that isn’t them dying like shjt. They ignore their pain. So that they are not duped again. I’ve seen patients on internal medicine in the ER who have been there 15 hours for real painful issues and these docs haven’t even bothered to treat their pain. And then I see all of this complaining about drug seekers on gomerblog. It feels like very other post. It’s different when you are on the inside looking in.

  75. This happens too many times during my shift. I even have pt tell me that I need to contact their dr and ask them. The ED is more like a walk in clinic with rude people thinking it should be ran like a MCDonalds drive thru!

  79. Maybe there should be a GOMIT blog to complain about doctor’s who contact IT do they can play World Of Warcraft on the hospital’s secure wireless, manage their stock portfolios, and scream at the poor helpdesk tech who got their phone call. To say nothing of these medical deities (MDs) immediately calling the Hospital CEO to complain about IT!

  84. But their family member (that just showed up at discharge and still cannot contribute to the history) knows everything wrong with the treatment plan you are prescribing…

  85. Or you get the lovely “I don’t have any history” on scene with EMS and then they go through the ABC laundry list of problems they have for the nurse.

  88. My favorite is when you ask them in the house or the back of the rig their medical history, meds and allergies and they are healthy as healthy gets and then you give the report to the nurse and they interrupt with their never ending list of medical issues and meds

  92. More like: “ED physician knows nothing about medical history, surgeries or medications.”

    Order “labs”, nebs, vanc, lasix, admit to medicine and label everything sepsis vs CHF vs COPD. Clean up before shift end, go snowboarding, drink Mountain Dew, get props on TV.

    ED is such a a joke.

  94. “No, I don’t have any medical problems” then hands you the bag o’meds. Oh I’m allergic to something. Don’t remember the name. But it nearly killed me

  97. I’m also young and not jaded… But I still find these articles light and funny. You gotta laugh at the common annoying themes in this profession to stay sane and feel camaraderie!

  102. Ha … Many moons ago I volunteered under the aegis of the Great, yet sadly tossed under a bus by a politically motivated press (for instituting what are now standard safety precautions) drday.com at sfgh er …. Best paraphrase: how’d that get in there? I dunno (that = light bulb, don’t ask …

  109. I’m getting pretty sick of gomerblog. Only Bitching about patients gets old quickly. And is this mainly for ER docs? Because I’ve never seen a gomerblog family practice or gomerblog psychiatry one ever. And I’ve been following for a while. I guess I’m just not as jaded and hate patients as much as these seasoned docs.

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