A TYPICAL DAY IN THE ER

Starts off at 06:45 when I receive report from the night nurse...

CT scan shows the lady with the headache has a metastatic brain tumor - shoot her up with Cerebyx (anti-seizure) and figure out how to break the bad news - my second guess would have been bleeding in the brain

Young black man, clammy, fruity-smelling - turns out he's in diabetic ketoacidosis - get his blood sugar back under control with some insulin, and quick, before his organs shut down and he has a heart attack - be sure to check his feet, because diabetics tend to get gangrenous feet that often require amputation

Nausea and vomiting - a common complaint but not to be taken lightly - make sure there's not appendicitis or diverticulitis or small bowel obstruction (all potentially life threatening if not surgically resolved within 24hrs)

Elderly man with a severely distorted twisted hip - turns out its dislocated so we sedate him and pull it back into place - keep an eye on his vital signs to make sure he doesn't go into respiratory distress or never wake up - if that does occur, administer reversal agents - otherwise, just get an x-ray to make sure its been properly reduced

Middle aged lady with scleroderma, terrible circulation to the extremities - fingers are all nubby, black and deformed, middle finger amputated - turns out her electrolytes are all out of whack ("not compatible with life" as the lab rat tell us) from days of vomiting - quickly pump her full of, essentially, concentrated Gatorade - but not too fast because the potassium really burns going in

One to lighten the day and keep us laughing - 50yo upper class woman spilled hot chinese fried rice in her lap last night and awoke this morning with massive 2nd degree blistery burns on her groin - apply bacitracin and a loose dressing and a pain medication prescription

The heart problems pour in - one lady in SVT (pump her with a 6 bolus Adenocard and hope that's all it takes), another in BBB, and another needing his fourth cardioversion of the decade

Frequent flier drunk/heroin addict homeless - treatment depends entirely on the physician that happens to pick up his chart - maybe we'll do a full workup and admit him, maybe just give him some narcotics to tide him over, or maybe just send him hoofin it - such a crying shame because he's actually quite handsome, has two university degrees and a daughter somewhere

Ethiopian flying in to Dulles Airport, has a Grand Mal seizure despite a clean health history - 12 lead EKG, head scan to make sure he didn't hit it hard, Ativan to make sure he doesn't seize again, padding on the stretcher and suction set up just in case he does seize again

Nine day old baby but 4 weeks premature, young mother's first - draw blood, do a lumbar puncture, make sure its not meningitis - turns out its Group B Strep

And then its 18:45 and I'm giving report to the night nurse taking over...
So that's a little sampling... I'll add more as interesting cases come along!