Tuesday, September 3, 2013

Weekend on call

DiaStat is an emergency anti-seizure medication in a liquid form, that's given rectally. It's for seizures that are hard to control. It's usually used when you're trying to avoid taking the patient to ER.

This holiday weekend, while on call, I was phoned by a lady who has a daughter with severe epilepsy. Her regular neurologist had already given the family a supply of DiaStat for emergencies.

So when they called to tell me the seizures were out of control, I had her mother give her a dose of DiaStat, without benefit. After I told her to give a 2nd dose, I got called again.


Dr. Grumpy: "This is Dr. Grumpy, returning a page."

Mom Seizure: "Hi, I gave Lisa the 2nd dose like you told me to, then I gave a 3rd dose of DiaStat on my own, and she's still seizing."

Dr. Grumpy: "You're going to have to bring her to the ER, and I'll meet you there. I can't safely give her any more outpatient medication."

Mom Seizure: "I understand, but is there anything else you could do? We really don't want to take her to the hospital. Is there another medication? Or another way of giving DiaStat?"

Dr. Grumpy: "Nothing I'm comfortable with, she needs to get IV medication, and further testing, and..."

Pause

Dr. Grumpy: "What did you mean by "is there another way to give DiaStat?"

Mom Seizure: "Well, the instructions say to give it rectally. I could try doing that."

Pause

Dr. Grumpy: "What the... you haven't been giving it to her rectally?"

Mom Seizures: "No. I've been putting it in her ear."

Dr. Grumpy: "IN HER EAR???!!!!!!!"

Mom Seizure: "Well, since seizures start in the brain, I figured squirting it in her ear would get it there faster. I was afraid putting it in her rear end would be too far away from the brain."

Pause.

Dr. Grumpy: "You need to bring her to ER."

36 comments:

Hannah said...

Oh jeebus...and hence you feel the pain of the private duty nurse who tries to combat this stupidity...

The Evil Receptionist said...

Gah! I've had to give DiaStat before, and the instructions are very clear and detailed. *facepalm*

Sounds like Mom needs a doc, too!

Tassiegal said...

Are you SERIOUS?? I am sitting here laughing my arse off.

Anonymous said...

That is scary!

Carol Sly said...

Oh dear. I can not imagine what is going through your mind in this situation.

After reading that I feel fricking brilliant! I can read and follow directions.

Holy hell.

Jimbo26 said...

Oh , dear . ;-)

Julie said...

Oh NO !!!!!!!!!!!!!!!!!!!!!!!!!!

Medic2RN said...

According to the mother, DiaStat is only given rectally to those patients with their head up their @$$. Obviously, this describes the caretaker, not this patient.

Anonymous said...

Hamlet?
--Queen Anne's Lace

awesomesauciness said...

These people walk among us, folks.

And, even more frighteningly, they apparently procreate.

I'll be in my bunker, for..umm...ever, so don't bother to call.

a.generic doc said...

Was the patient's name Dumbo? How the heck could she get a full dose into an ear?

Anonymous said...

...I'm guessing that she needs to go into the ER for foreign body/fluid in the ear..?

Orli said...

Sometimes when I hang up the phone on a particularly obstinate client who doesn't want to bring their dog or cat into the ER despite such important troubles as "baby stuck in birth canal for 2 days" or " constant seizing for several hours" I can at least console myself that if it was a human kid they'd rush them in.

Thanks for killing my hope, Dr. Grumpy.

Anonymous said...

"Well, since seizures start in the brain..."

Which is why a little bit of intelligence can be so much more dangerous than none at all!

bobbie said...

Ye gods and little fishes...

Anonymous said...

I hope the patient is ok.

Crazy RxMan said...

The stupidity of people never ceases to amaze...

Silliyak said...

Well this is certainly one for the anals, I mean annals

Cape Cod Step-Mom said...

Read this aloud to my fellow commuters....the collective gasp was quite amazing

Patti Cadwallader said...

OMG....Really? People this stupid should be barred from having children or even a drivers license.

Fulfilling Foodie said...

I am afraid this situation reminds me of a person who gave their cat flea treatment orally rather then on the back of the neck like the instructions stated. The cat unfortunately did not survive after being brought into the vet office I worked at during the time. Its like the saying "measuring twice, cut once"...Read twice, live once!

Hockey Medic said...

I've got one up on that. My paramedic instructor told the story. Girl comes into the clinic, obviously pregnant, but swearing she couldn't be because she took her birth control daily. When further questioned about how she took the BCP, it came to light that the patient stuck them "up" there, since that is where babies come from. Taking pills by mouth didn't make sense.

Darwin's Theory of Natural Selection really needs to be allowed to happen in the human species.

Anonymous said...

Was Child Protective Services waiting in the ER?

Frantic Pharmacist said...

Oh, good Lord. Probably one of the many people who didn't want to receive pharmacist 'counseling' if it meant putting their cell phone down.....

rapnzl rn said...

THIS is why I have my hospital discharge patients read me their discharge med list (that I spent 30+ minutes creating), complete with dose, frequency, and ROUTE. Out loud. With an "open book" test to conclude.

*facepalm*

bluetoothbuddha said...

PR goof ups reminded me of this intern, who had the resident ask him to take a 'sleeping PR'* on a patient with Hashimoto's thyroiditis during his night shift. There is nothing in the chart next morning, so the intern is asked to explain.

He says, "I tried several times, I really did. I waited till the guy fell asleep, and as soon as I start the procedure, the guy's up again!"

*PR in this case stood for sleeping pulse rate, which takes out variables like anxiety and stress related to thyroid pathology.

The intern, of course, tried to do the other, more commonly ordered, PR or 'per rectum' -- a rectal examination.

Anonymous said...

I used to do a lot of work for the medical branch of a market research company. They were looking at what form migraine patients would like to have a new medication as: "nasal spray would be good as it's closer to the brain"

And on another note: a couple were being investigated after several years of marriage and no children. It occurred to one of the staff that the woman's umbilicus was very deep.

At least how to take a specific medication is not what you'd describe as a natural instinct...

Anonymous said...

I think this was said by George Carlin...

Think of how stupid the average human being is. Then realize half the population is stupider than that.

Packer said...

I think I have found the solution to a certain hemorrhoid problem that has been unresolved for sometime.

Oh,So now I am not allowed to say hemorrhoid ?

Anonymous said...

Oh my. I thought it was bad when a parent called me to say he couldn't get any more of his daughter's amoxicillin suspension in her ear. I had explicitly told him BY MOUTH during consultation (because he actually asked if he should put it in her ear for her ear infection), but he ignored me and put it in her ear anyway.

Anonymous said...

The rationale is much like that branch of mumbo jumbo called homeopathy that sells a lot of the front end stuff in the gas station for various and sundry symptoms; not really treating the issue or cause --no comprehension of cause and effect.

Doc Rugrat said...

Oh crap, you got one of my patients. Sorry, Dr. Grumpy.

peace said...

The poor little kid. My heart is still hurting, God help here.

Anonymous said...

My sister has had epilepsy since she was just shy of 2 years old (I was a fetus at the time), so growing up "the butt medicine" was just a thing. One of those, "Yeah, sometimes life is weird and a little embarassing, but what are you going to do?" things.

Now I'm really grateful that my parents have above average IQs, because apparently those are necessary.

Cutter said...

in my typical nightly avoidance of doing work I happened upon your blog. I am currently crying at how ridiculously funny this story is!!

Geoff Brown said...

Peter Griffin: Hey, Mort... do these suppositories come in any other flavors?

Mort Goldman: Peter, are you EATING those?

Peter Griffin: [sarcastically] No, I'm shoving them up my butt... of course I'm eating them!

 
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