Pooling for Patients

Since we’re a cardiac floor we have a large contingent of frequent flyer patients.  Most common are our CHFers and chest paineurs, along with the occasional COPDers.  Some of them are very nice folks, they’re respectful and pleasant, others just downright nasty.  You learn their quirks.

One guy who has “adopted” us as his new tune-up clinic is actually one of the nicer of our bunch.  He’s a CHFer who has very tenuous grasp on the idea of a low sodium diet, which invariably leads to his admission for fluid overload/CHF exacerbation.  We’ve tried really hard to teach him that eating at Wendy’s, eating bacon and movie theater popcorn is not the best elements of a low sodium diet, but it doesn’t seem to stick.  The last time he was in though we decided to have a little fun.  Looking back at his previous admission I looked to see what is BNP level was.  BNP, or brain natriuretic peptide is a protein secreted by the ventricles of the heart due to excess stretch brought on by fluid overload of the myocardium.  It’s a good indicator of the fluid status of a patient in acute decompensated heart failure.  We use it to determine how bad the failure may be.  It’s not always the best nor the most accurate, but it works pretty well.  If the level is under 100pg/ml it is considered normal.  Values above that show increasing levels of heart failure.  Our daignostics cut-off at 4500pg/ml, but at that point, the number really is maningless:  it’s high.

Looking to have some fun I announce, “OK, Larry is in the ED, I’m pretty sure he’s going to get admitted.  Anybody want in on a pool for his BNP level?  It’s a buck to buy in, the closest gets the pot.”

“Who?” asks Charlie, “Do I know him?” she continues.

“Yeah, he’s the one with the crush on Tanya.” I said.  Which wasn’t far from the truth, he’s a young guy and when he’s admitted and Tanya is on, he comes and hangs out by the nurses station.  He usually lives inthe 1500s range when he’s admitted.

“He’s the one who eats at Wendy’s right?  Put me down for 1850.”  Charlie says.

I put in for 1500.  No one else wanted in.  I think they kind of thought it was a bit weird that we were pooling on our patients.

Sure enough Larry comes up.  And his BNP?  1225pg/ml.  I won, being the closest, but I didn’t have the heart to take Charlie’s money.  Maybe next time.

One Comment

  1. That’s Genius!

    We bet on BAC’s and diagnoses occasionally…but never BNP’s and on the tele floor it would be a far more frequent money maker than drunks.

    You should win an award for that thought! 🙂


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