From the monthly archives:

October 2008

Do Not Touch

Do Not Touch

It’s tough to say what the dumbest injury I’ve ever seen is, but I’ll submit this for your consideration.  I had a patient who noticed a rattlesnake on the road, and decided to save it.  He was concerned the snake would get run over by a car.  He therefore walked up and grabbed it by the tail, thinking he would “sling it to the side of the road.”  Of course, the snake simply turned back on him, and bit his hand.

At this point, the patient decided that instead of saving the snake, he would club it to death with a large wrench.  For some reason, he kept the dead snake, and put it in a bucket.  He came into the ER, and had to get anti-venom for his snake bite.  I asked him why he thought it was a good idea to grab a rattlesnake, and he argued that he said “I grab snakes all the time, and I never get bit!”

“You mean, until today,” I said.

Two days later, he was back at home, and was “fooling around” with the dead snake.  Incredibly, he somehow was bitten again, this time on the other hand.  I’ve heard of bites from dead rattlesnakes happening right after they die, but I really don’t know how this could have happened two days later.  Fortunately for the patient, he did not appear to get anymore venom into his hand, but he did develop a wound infection and he came back into the ER for antibiotics.

{ 0 comments }

Q:

I’ve had shingles, can I still get the vaccine?

Anonymous

A:

Yes!

The shingles vaccination was licensed in 2006 to prevent shingles outbreaks and the pain that can occur from the rash (post-herpetic neuralgia).  It is licensed for use in people 60 years or older.  It can be given to patients who have already had shingles, and is thought to provide some benefit to those patients.  For more information, log onto the CDC’s excellent website at:  www.cdc.gov/vaccines and also speak with your primary physician.

{ 0 comments }

Bus Crash Scene

Bus Crash Scene

Yesterday there was a bus crash in Colusa, CA with many injured patients and several fatalities. This happened just on the heels of a horrible train crash in Southern California that killed 26 people and injured dozens. Many people wonder how emergency rooms deal with a situation where suddenly there are many victims from an incident like this. I can tell you, it’s not easy.

California manages trauma through a network of “trauma centers.” These are essentially hospitals which have the capacity and ability to manage complex trauma victims. These hospitals must have surgeons that are readily available, immediate access to the operating room, and a host of other resources. But when there is a big accident, any single trauma center will be stretched beyond its capacity very quickly. Typically, a “Multi-Casualty Incident” is declared by regional trauma authorities and patients are then distributed to several hospitals. Hospitals are notified of the event and then quickly determine what capacity they have for patient care. In the case of the Colusa bus crash, patients were sent to 7 regional hospitals. In general, events such as a bus crash can be dealt with efficiently and effectively by California’s trauma system. However, the emergency medical system is stretched, and trauma specialists are concerned about our ability to respond to catastrophic natural disasters such as large earthquakes, or acts of terrorism. For more information,  visit www.emsa.ca.gov.

{ 0 comments }

C. diff "Super Bug"

Q:

I recently read about “super bugs” (Clostridium difficile) or C. diff being prevalent in hospitals and also MRSA staph too. You are in a hospital everyday and in “the middle of it” as an ER Doctor. Why don’t you get sick too?

 

A:

Unfortunately, we do! ER docs, nurses and other hospital employees are at huge risk for developing these infections, and that’s why we are absolutely obsessed with hand washing, use of gloves, and hand sanitizer. The frightening truth is that working in the ER puts us on the front line of dealing with these infections, and we have to accept the risk. I personally wear a lab coat which covers most of me, and the coat stays in the hospital and is washed frequently. I wash and sanitize my hands repeatedly throughout the day, and definitely between each patient. I try to avoid touching my face, unless my hands have just been washed. C.dif, MRSA, certain types of meningitis, hepatitis, HIV, are just some of the bad bugs I am trying desperately to avoid as I go through my career. Now that I think about it, maybe engineering would have been a better job. . .

{ 2 comments }

Q: I just heard that people all over the country are getting sick from salmonella poisoning. Is this a bacteria, and how can I avoid it?

A: Salmonella is a common food-bourne bacteria that can cause infections in the stomach and intestines. It is often found in chicken. The people that are getting sick in this recent outbreak appear to be getting it from not cooking chicken meals thoroughly. In some prepared frozen chicken dinners, the chicken appears to be fully cooked when it isn’t. So people, unless you like the idea of spending several days in the bathroom, and maybe the hospital, be sure to cook your chicken!

{ 1 comment }