Tones drop for a male with a bleeding disorder that cut his finger.
Band-aid brigade to the rescue!
We arrive to find our patient loosely holding a paper towel over the injury. That’s less than helpful, but I’ll give you a B for effort.
I grab his finger with a 4×4 (hey, it was handy), elevate, and squeeze hard enough to turn the distal segment white.
We get to talking – OPQRST and all that. Turn’s out he’s been bleeding for a few hours now. Excuse me? Let’s talk about this bleeding disorder…
Apparently the last time he had received so much as a minor scratch, it took nearly a week to stop bleeding. Oh, and he’s never seen a doctor about it. Of course not, why would he do that? At this point I check the 4×4. Still bleeding.
Fine. This is a good excuse to let the probie crack an ice pack. Slap that on, see what happens. A few minutes later he’s still bleeding.
Fine. I find a brachial pulse, ask the probie to push here. A few minutes late the bleeding has…… slowed.
Hmmm… Well… I… Uh…
Even though it is the next step in bleeding control, on principle I refuse to put a tourniquet on something that amounts to a papercut. Just no. The patient reports that he is now feeling dizzy. I get a fresh set of vitals to fins his heart rate is elevated for someone who has been sitting on the couch. Really? Hypovolaemia from a paper cut? Really? It’s just a papercut? Is this seriously happening?
Fine. Let’s go to the hospital We hop into
the gutless wonder our vehicle and tear off to St Closets as fast as we can – meaning a snail could easily outpace us. On our way to the hospital I call ahead and ask if they would like me to drop our patient off in the waiting room or go through the ambulance door. I’m told it’s slow, so to come on through the ambulance doors.
The sliding doors open and the charge nurse glances at the three of us walking into the ED, realising that our patient is indeed holding a 4×4 over their thumb. She gives me a stern look over her glasses. Without saying a word, she speaks volumes. Are you seriously bringing “I hurted my finger” to my level 2 trauma centre? Her criticism resonates in my skulls like she’s communicated telepathically. Unfortunately, tin foil hats are not part of our standard PPE, so I have no protection from her silent criticism as I walk my patient to the indicated room.
St Closets is the only hospital in my city, so it could also be called St Onlys. This was also before the hospital opened an urgent care clinic, so the ED is the only medical attention you can get outside of business hours. Yes Nurse Ratched, I am bringing you my patient with her boo-boo. And I’m doing it proudly, as we at the band-aid brigade rarely get to transport patients. So if you please, kiss it and make it better, and we’ll be out of your hair before the Fire Department can bring you the town drunk for the evening.
I give my handoff to an equally sceptical nurse at the bedside. She sees that our patient has now bled through the 4×4 I applied earlier. A tech puts on a fresh one and matter-of-factly adds a pressure dressing. “There” he seems to say as he walks out of the room.
I poke my head in 20 minutes later. The pressure dressing has bled through. Told ya so.
A physician , nurse, and tech enter the room with a shared look of consternation/frustration/irritation/annoyance/awe/disbelief. It’s decided to stitch it shut. Yes, what amounts to a paper cut is about to be stitched.
Two stitches later the bleeding is finally controlled. The “injury” is then covered in fresh pressure dressing and splinted to prevent any movement from tearing the stitches. With all this wound care, our patient’s thumb is now at least five times its normal size. His face seems to say, “FML.”
chuckle keep a straight face and very professionally call us back in service.