ED Consults Vascular Surgery for “Pulseless Foot” on a Pulseless Human

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Saint Louis, MO – Mr. James Rice originally presented to the John L. McClellan Memorial Veterans Hospital in Saint Louis with shortness of breath last Tuesday, but he was found to have a pulseless left foot upon arrival. What happened next is unthinkable.

It was a crowded evening at the John L. McClellan Memorial Veterans Hospital and every emergency room was full. Mr. Rice had to wait in the waiting room for a couple hours due to the lack of space, but he was eventually roomed by Betsy, RN. She didn’t notice anything unusual at the time, and described Mr. Rice as a “quiet but courteous man covered in blankets.” She did astutely notice that his left foot was uncovered and cold. She immediately notified the ED staff, who presented to bedside within minutes.

The ED doctor (who prefers to remain anonymous) confirmed there was indeed a lack of a palpable pulse in the left foot. Per the ED physician’s H&P, he was described as, “No acute distress, mild pallor, eyes closed, no obviously increased work of breathing, abdomen non-distended, pulses absent in the left foot.” Vascular surgery was immediately consulted.

Dr. Thomas Nguyen (vascular surgery) received the consult that night. He was already in-house, and went down to examine the patient within the hour. “I uncovered Mr. Rice upon my arrival and he had clearly been dead for hours, not a single pulse was found,” Dr. Nguyen regretfully explains. “I would’ve liked to consent him for a left lower extremity femoral-popliteal bypass post-mortem, but there was no family around.” Mr. Rice was then pronounced deceased.

Veteran Administration hospital officials are baffled how this occurred. His nurse, Betsy, speaks out. “He was covered in blankets with his left foot sticking out when I first saw him. The foot definitely didn’t have a pulse. I just thought he was cold.”

Mr. Rice’s funeral services will be held this Thursday at 7:00pm at the Saint Louis Memorial Parlor on Caroline St

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