Stupid Patient Tricks

I heard about this from a friend of mine.

Dood comes in to the ED with chest pain.  Prior history of cardiac issues including prior stenting.  And a raging drug habit.  Dood gets the million dollar workup showing he’s probably got some new issues with his coronary vasculature and ends up taking a trip to the cath lab.  Lone behold there’s a new blockage and he gets a shiny new stent to fix him up right good.  But here’s where the fun begins.

Claiming he’s having a “reaction” to the Versed he becomes a raging asshole and as soon as the nurse steps out of the room to get supplies he bolts.  With an arterial sheath still in place!

Many times the cath lab sends the patients out to the floor so the sheaths can be pulled on the floor thereby increasing throughput or something like that.  An arterial sheath is a large bore introducer that is used to gain access (in many cath lab cases) to the femoral artery so that diagnostic and interventional catheters can be passed up the femoral into the aorta and then the coronary arteries.

So dood is on the loose outside our facility with a 2-3mm hole in his femoral artery plugged with the introducer which really isn’t built for a whole lot of movement.  If that was to come out, there might be issues…  Security is called, who then call the local PD to find this guy.  They find him (I’m guessing it was at our local watering hole…) and bring him back to the ED where the sheath is pulled.  But the ED docs want him monitored for  any complications post-pull.  Y’know, like bleeding, hematoma, occlusion of the artery.  Minor things.  But dood is still a raging asshole and demands to leave.  And for once, the docs see that to keep him around will only cause issues, they cowboy up and let him roll.  You still have to shake your head and wonder what was so important to get up just after having a stent placed, with a large hole in your femoral artery to decide you wanted out.  Guess we’re adding Versed as an allergy for dood now!

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