The Worst Bone to Break

I see lots of broken stuff.  Noses, hips, fingers, toes, wrists, ankles, necks: all of which suck in their own unique way.  Still, when it comes to flat-out squirm factor nothing tops the broken penis.

Just getting the story is awkward.  I put up the professional facade, pretend it’s business as usual, but there’s no getting around the uncomfortableness that hangs over the room for both me and this poor unfortunate dood.  ”So the two of you were having intercourse?  And she was on top of you…no…oh ok missionary style.  And you’re saying you came out, missed on the way back in, bumped up against her and felt a pop?”

Gah!  Enough talking, although pulling back the sheet isn’t any better as I see what appears to be a giant eggplant sitting between his legs.  ”Holy bejeezus!!” I think.  ”Well that appears to be a bit swollen doesn’t it?” I say.

There’s no actual penis bone to break, instead an erect penis has a markedly thinned and relatively unelastic tunica albuginea.  With enough force this tears resulting in damage to the underlying corpus cavernosum, aka a penile fracture.  The treatment is a trip to the OR, and off he went to have the underlying blood clot evacuated and tear sewn back together.

Pretty big mood killer, to say the least.

(Cerita diambil dari blog seorang ER Doc)

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Hmmm, pengalaman yang aneh (tapi seru), hehehe.

Punya pengalaman anda sendiri?

Harus diapain si Pemabuk ini?

Gotta Keep it Together….

I remember a case from residency that really tried my sense of ethics and my desire to do the right thing. A bad set of traumas came in one early morning (about 5am) after two cars collided on the highway. The one car was comprised of a family on their way to the airport for vacation. Two kids, mom, and dad. The other was comprise of a single drunk young male. The drunk guy crossed into the other car’s lane, causing the family car to lose control and fly off the road. The drunk guy ran into the guardrail. They were all brought to us – the mom had a broken femur, the dad a broken shoulder, the kids – one had a nasty head laceration, stable spinal fracture, and a concussion, the other had broken ribs and facial trauma. The drunk guy had nothing except a big scalp laceration. I got assigned to the Dad and the drunk. As I heard more about the accident, I got more and more angry at the drunk. The family luckily all survived but were badly f**’d up and I knew would have a long and painful recuperation. When I went to try to examine the drunk he became combative and I had to sedate him. The guy was huge as well. After a negative CT I had to suture him up. He remained very difficult to deal with despite tons of Haldol and Ativan and was in 4 point restraints. Finally he was just moaning and by the time I started suturing, the lidocaine had worn off. I was THIIIIIIIIS (my thumb and finger right next to each other) to just sewing him up with no anaesthesia just a punishment for what he had done (the police did not arrest him for some unknown reason). I wound up giving him more lidocaine but I was not in the least bit upset by his screams from it’s injection. He also got a borderline punitive foley. I was also very close to pointing him out to the injured family and leaving them alone with him in the restraints and a blackjack in the Dad’s hand.

What do you think I should have done?

(Article was copied from erstories)

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Judul aslinya ‘Gotta Keep It Together”, kami coba sesuaikan agar pengunjung bisa cepat menangkap maksud cerita itu dan bisa membagikan pengalaman atau tips ketika berhadapan dengan pasien seperti di kasus diatas.

Silahkan comment-nya,

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Pentingnya Ambulance 118

Ambulance merupakan sarana terpenting dalam perawatan pra hospital pada patient post trauma di lapangan. Selain dilengkapi peralatan yang menunjang seperti O2, Ventilator, EKG dan tentunya obat2an emergency, ambulance juga di dukung oleh staff yang sudah terlatih dalam menangani patient yang memerlukan tindakan yang cepat untuk mencegah kondisi kritis atau bahkan kematian. Sehingga di perlukan pemahaman baik dari rumah sakit ataupun masyarakat tentang peran ambulance itu sendiri dalam menurunkan angka kematian. Ambulance tidak hanya melayani panggilan/ oncall dari masyarakat ke rumah sakit tetapi juga antar rumah sakit yang biasanya antar ICU. Ini disebabkan karena keterbatasan Bed ICU sehingga sebagian rumah sakit lebih memilih untuk merujuk patient ke rumah sakit lain dengan menggunakan jasa ambulance. Dalam hal merujuk patient kondisi kritis tentunya staff ambulance harus benar2 memahami, mengkaji dan mengantisipasi kemungkinan2 buruk yang terjadi saat di pejalanan. Dalam hal ini kesetabilan kondisi patient sangat di perlukan terutama pada unintubated patient. Tidak jarang petugas ambulance di suruh melakukan intubation di rumah sakit sebelum patient di rujuk karena keterbatasan skill yang dimiliki oleh petugas kesehatan di rumah sakit tersebut. Ini juga merupakan salah satu alasan mengapa rumah sakit lebih memilih jasa ambulance terutama 118 dalam merujuk patient.

(Sumber : emergensiku.blogspot.com)

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tulisan yang menarik.

mungkin bisa diposting disini bagaimana respon masyarakat terhadap layanan ambulance 118?

apa dampak kemacetan/kepadatan daerah (contohnya Jakarta) terhadap response time dari suatu panggilan emergensi?bagaimana 118 mengatasi hambatan2 yang ada?

apakah 118 melayani masyarakat yang tidak memiliki asuransi?bagaimana sistem pembayarannya?kan pasti berbeda dengan EMS/ambulance service di Amrik sana yang pasien2nya paling tidak sudah memiliki asuransi sendiri?

salam,

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