Eyes Yoo Close Together

Dangerous?

Can home visits for home medical emergency are dangerous? Can you send out small doctors at night? Why the doctor is sometimes uneasy?

There was, for example, the home visit last week. Shabby Building, fifth floor, the apartment door ajar. No response from inside. Chaos, disorder and decay already in the hallway of the apartment. Empty two-liter bottles of wine anywhere. Really everywhere. Filthy dishes piled up in the kitchen. Half empty pizza boxes. Moldy carpets. The powerful Russian was delirious in the next room. But before the doctor took care of him, he searched the rest of the apartment. Ready for anything, there was still lurking could.

There was, for example, the Fixer couple with the dog. Dilapidated apartment without furniture. Cold, old tobacco smoke. Greasy, hazy windows. He was seriously ill and on withdrawal. Wanted to benzodiazepines. The two were brash and demanding than the doctor did not believe them. Wanted to see for myself what was in the suitcase. Had the prescription forms certainly like to put in themselves. Like a scuffle would have ended? Had been threatened with infected needles? For example, there were

repeatedly southern men who wanted to spray their malaise but only got good advice. They do not understand. The were already demanding. Especially if they also ten have to pay €. For example, there are

repeatedly called on members of nursing care, which the doctor can not do the favor of hospitalization.

And there are always large dogs, dilapidated buildings, dark corridors, dissatisfied patients or relatives, violent alcoholic.

sure, the rescue service will always put dangerous situations on highways, construction sites, in factories. But the primary care emergency service is accessible for alone. Down the street waiting for a taxi driver. And a doctor's bag filled to the brim, which form thick binder with recipes and practice fees collected could one day Desires awaken.

Yes, home visits can be dangerous. Yes, small doctors are vulnerable at night.

The doctor takes the following precautions: Always light with you. Always remember the way back. Never follow a request to take off their shoes at the door. Never enter a dwelling in which a larger dog is moving freely.

But above all, be sure to do the right thing.

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paracetamol

paracetamol? Is a painkiller. Many patients believe pain but not its effect. At any effect. "Fever suppositories for children?" they say incredulously "to help me?"

But paracetamol acts. Sometimes it works even deadly.

She was a nurse, young, early 20 She had lower abdominal pain. As each month. However, they took a paracetamol tablet. Soon she felt sick and dizzy. It collapsed when the emergency bell rang at the door. Before losing consciousness, she could explain. The blood pressure sagged. Anaphylactic shock. Ventilation, cardiac massage, catecholamines, cortisol. From her apartment door to the ambulance. She was so unstable that the resuscitation was continued in RTW. Almost three hours. Unsuccessful. She died in the late afternoon, four hours after paracetamol ingestion.

What she told the emergency physician had? That she was allergic to paracetamol. That was even in their allergy identification. A few months ago it was you ever been so similar to a paracetamol. Since they had had to test it. They had hoped, anyway, the tablet is well tolerated for?

Since then the doctor prescribes medication or a bit more reserved.

Even paracetamol.

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unexpectedly Monday morning at nine-under

Monday morning at nine: "Non-responsive person on site!" The emergency doctor was an older construction worker at the bottom of a trench: shaky, confused, frightened, obviously postictal. What had happened?

The man was unemployed for months this morning, and had finally started a job on the site. Sober. For the months of unemployment, he had apparently been drinking all day. Also in the morning.
the new job lined up sober, slipped into the alcohol withdrawal, convulsed. Alcohol withdrawal seizure is called something like that. Now, dazed but not smooth after the seizure. The ambulance brought the poor fellow in neurology.

later than two hours: car accident in the same district. Car in front lamp, in a straight line. Cause you can not, drivers can not be addressed. But known. And postictal. Again. The Braunüle was still in the back of the hand. What had happened?
The man was straight escapes from neurology and had trying to master the way home with his car. Kramp second attack. This time surgery.

Such things happen, Monday morning at nine.

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sugar addiction

One thing we remained in the study of diabetes in mind: Both sugar shortage and excess sugar can cause confusion and unconsciousness.

But the fact that both extremes that cause over-and hypoglycemia, the very different histories and clinical pictures fall only on us again when we saw the first patients with Hyp-O-glycemia.

He was old, thin and sullen. His wife had called the ambulance, because he signs of hypoglycaemia was shown. She had tried with good words and jelly sandwich to raise its sugar. But it did not help. He refused. Was sullen and stubborn. He sat at the kitchen table arrived ahead of his bread and jam as the emergency physician. "They scissors to hell, what do you want from me?" Get out of my house! " growled the old man to the ambulance. Measuring blood sugar? Access basket? Not him. The ambulance tried it with good words. Praised the delicious bread and jam. Referred to the concern of the wife. Warned of the sugar-shock. Nothing doing.

The old, withered man was weaker, but always aggressive. Tried to scratch an ambulance. Railed against himself. So it was always when he was hypoglycaemic, the woman said.

The decisive plan came from the experienced paramedics: The feather bed was spread on the kitchen floor. By joining forces, the little man was laid out and recorded. Now he was active again: cursed, spat, scratched and bit around. Worst insults and curses, he accused the physician on his head. On behalf of his profession was the doctor to blame for all the misery that had happened to the patient: reduced pension amputated leg, failed surgeries and countless hospital stays. Never the doctor, who was now on the patient, had been hitherto so insulted.

Nevertheless, he succeeded in an increase in the fragile veins of the struggling old man. And as soon flooded the first twenty milliliters of 40 percent glucose the organism could hear the thrashing and cursing on suddenly. "Excuse me, sir, I have offended you?" he asked timidly. While he was down on his bed acts together and jam bread turned he confessed shamefacedly that These kinds was not made for the first time. He was sorry and he apologize.

The blood sugar level, which had been removed after laying the Braunüle showed later a value around 30 mg%.

met in his later career the doctor again on hypoglycaemic which herumtigerten restless, confused. And often fought against a helping action. Developmentally, the search for the saving carbohydrates, when we are not to be stopped? Who knows?

Only three times was the emergency doctor in the following years when the old man at home. Two-time hypoglycemia. The third time, determination of death.

The woman had been shopping.