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20 March 2012

just one nightshift

During my night shift last night, I met this very pleasant gentleman. He was brought in by ambulance with two falls at home. When an elderly gentleman had a fall, it is always important to establish "How they fell?, either mechanical fall or there is a medical reason such as Heart attack.

Lets say his name is James.
So I started with the question, "Ok James, do you want to tell me what happened and how did you fall?"
He replied: "Oh doc, I just crashed down to the floor"
Me: "OK, Is that because you slipped on the floor or tripped over something?"
He: "No I don't think so, but I have 2 lovely dogs"
Me: "Ok, good, but can you tell me a bit more about your fall, James?"
He: "Oh, I don't know Doctor, I think I just collapsed. You know, my dog name is Plauto and Jessie. They are two lovely terrier. They are brilliant. when I say his name .............." its go on about 3 - 4 mins, So I had to stop him and said

"Alright James, I'd love to listen all about your lovely dogs, but now we are really busy. Shall we talk about your fall?"
He: "Yes, of course you are a busy person. Where are you from doc? Do you have a dog?" 
here he goes again!
I replied very patiently: "Erm, No I don't have one. Listen James - did you have chest pain when you fell?"
He: "Oh nooo, I was just getting some food out of the packet for my Plauto and Jessie when I fell" My heart started fluttering with some hope, maybe we are getting a little closer.
Me: "Right then, what happened?"
He: "well Plauto looked like he was in pain?"     Arrghh ... 

Around midnight, one Staff Nurse hurried and told me that there was a lady having seizures (Fits) in cubicle but strange she fitted only when she saw a staff passed-by or entered her cubicle. So I went in the cubicle to review her. She shouted as soon as she saw me "Oh doctor, I think I am having fits again, please please help me" with both hands and legs shaking, eyes wide opened and looking alert.
I replied "Ok Sue, lets get a needle (I meant a small plastic tube or cannula in her veins for Intravenous access) in your arm first, so that we can give you medicine to stop you from fitting. Of course, I don't want to miss or hurt you, so I need you to stop shaking this hand " Then funnily enough, she stopped shaking one hand but continued having - what-she-called -  Seizures with the other hand. 

To be continued ...