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  • Review of the ER. OMFG! Anyone with medical experience - here's the $25,000 question. Patient - 64 overweight female complaining of extreme nausea and vomiting(almost 24 hours) and a few days unable to have a movement. Not very alert, BEGGING for water or ice chips. You do NO CBC. No blood or urine test of any sort. WHY???? A blood test likely would have shown blood sugar well into the mid 400's. A urine test would have shown ketones through the roof. Either of these simple tests would have likely gotten her admitted on the spot to get her newly discovered diabetes under control. Instead - you do an X-ray to make sure there's no obstruction, give her some prescription anti-nausea drugs and laxatives and send her on her merry way. Well, her husaband brought her back to the ER - while on vacation in Washington State just 3 days later. By then her blood sugar was well over 500, her ketone level was atrocious, her pH was dangerously low. Then she got to spend 2 days in ICU. Intensive Fucking Care! In a state far from home. For what it's worth - when the hospital in WA recieved the records from PV and saw no blood or urine test was taken, they couldn't understand WHY. If nothing else, a CBC to check for infection would have been one of the first things they did. (And, in fact, WAS one of the first things they did.) Hours in your ER for nothing. Minutes in Washington, and she's in the ICU. She should not have been released from your ER - she should have been admitted. And maybe with the extra 72 hours to work with, ICU could have been avoided. And I'd be able to see my mom in the hospital. She's out now - and on her way home. No thanks to you.
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