Emergency Care In This Day & Age

[SlickTony]

Last night, my son dislocated his shoulder. Or his arm. Whatever. Anyway, that ball & socket arrangement. He was in Taekwondo 5 years and nothing ever happened that he required medical attention, but last night he was in a church youth meeting and he was throwing a ball and he threw his shoulder out.

Because his car needed a new battery, he and I were in church together--he was at Youth & I was in choir practice. 15 minutes before choir practice would have let out one of the kids came to the practice room for me & told me. So I took off out of there like the proverbial bat and went to Wesley Hall & sure enough, there he was with his shoulder all funny and him in intense pain.

Well, this is the kind of thing that used to happen to me from time to time, usually when I was in the back yard playing catch with my dad--I have loose joints. It was painful and scary but I was always able to get my arm popped back into place. & those of you who've read Outlander will remember that when Claire Randall met Jamie Fraser, the first thing she did for him was to put his dislocated arm back in its socket. Since it had been some 35+ years since I'd dislocated my arm and I am not a recently demobbed Army nurse, I hesitated to fool with it and drove him less than a mile to the local McClinic, which started out as a privately run place and later became part of the Baptist Medical Center system.

Can you believe it? They wouldn't treat him? Liability issues, dontcha know. They told me to take him to the ER. So I had to drive him across the river downtown and across the river again to Baptist Hospital. Even taking him to the McClinic, he'd felt it whenever I turned, whenever I changed lanes, whenever I stopped and whenever I came away from the light.

One thing I will say about Baptist, unlike their satellite place, as soon as they saw him with is shoulder all awry, they started processing him at once. Since it was his right arm, I had to put my chop on all the paperwork.

They put his arm in a sling. They put him in a wheelchair & wheeled him to one of their treatment rooms. They put him on a bed & tried to get him to lean back on it, although he was in too much pain to do that. A radiologist came & took a Before x-ray. Another tech (who turned out to specialize in orthopedics) came & did some blood work. As a gallon donor, I was impressed at the deftness with which he handled the needle & stent, for a saline drip & the meds they'd give him later. (Of course, it helped that my son has good veins). The doctor came & looked at him. A nurse came & hooked him up to a monitor, with five of those electrode things you stick to the torso, & a clip on his forefinger to monitor his oxygen levels, & an oxygen mask. They gave him something for nausea (I forget what) & Dilaudid & Ativan. As soon as he was out they eased him back onto the bed & the doctor put his shoulder back right, a procedure that took about 2 seconds.

Presently he started to come out from under, & after that he fell into a natural sleep--I could tell because he snored. The tech who specialized in orthopedics gave him a new sling, pointing out that his arms are a tad longer than other people's & the one they'd given him would cut off the circulation in his hand because it dangled down. The radiologist came back & took an After x-ray. The doctor said that if he'd wake up and stay that way for at least 3 minutes, they'd discharge him. They turned on the TV & we talked for a while, & they came and disconnected everything & discharged him. He was still a little woozy when we went back to the parking garage.

What with having to stop at the all-night Walgreen's to pick up his prescription, it was around midnight by the time we got home.

He knocked his arm out of its socket. When did this event start to acquire all this medical attention?

 

[freshface]

He knocked his arm out of its socket. When did this event start to acquire all this medical attention?

When the medical community recognized the complications that can happen when it's not done this way. He could have fractured his shoulder blade or the head of the humerus. To put it back, they needed to know which direction it dislocated and that there was no fracture. He was sedated both because it's kinder that way and because if he resisted when they popped it back in, they could tear ligaments or muscles. The standard of care is to check for fractures, sedate the patient, relocate the joint, and ensure that the joint is relocated. The catheter, ECG, pulse oxymeter, and oxygen mask were all so that they could monitor and respond if he had problems while sedated. It sounds like he got great treatment.

 

[SlickTony]

When the medical community recognized the complications that can happen when it's not done this way. He could have fractured his shoulder blade or the head of the humerus. To put it back, they needed to know which direction it dislocated and that there was no fracture. He was sedated both because it's kinder that way and because if he resisted when they popped it back in, they could tear ligaments or muscles. The standard of care is to check for fractures, sedate the patient, relocate the joint, and ensure that the joint is relocated. The catheter, ECG, pulse oxymeter, and oxygen mask were all so that they could monitor and respond if he had problems while sedated. It sounds like he got great treatment.

I'm sure he did, especially since I believe our insurance covers it all, as at no time was I asked to whip out my bank card. It's just such a far cry from when it used to happen to me. I didn't know there were such complicated issues. He is 6'2" and weighs 140, IOW, very slender and lanky. He was just throwing a ball. Indoors, in a fellowship hall; it's not like he was pitching for a softball or baseball game. He has the loose joints from my side of the family, I guess.

 

[SlickTony]

The Time Before Last My Son Was In the ER

...was when he was still a little boy--it has to have been after '99, because we'd moved into our house. We were trying a medical clinic that was closer to us than good old Arlington Acute Care, which later became the Baptist McClinic that I took him to first.

He was complaining of this pain in his groin, and when we took him to the clinic, the young female doctor who looked at him thought he might have an inguinal hernia, so she referred us to the ER, the same one we were at Thursday night. That's what made processing him a tad quicker than it might have been--they already had his info on file.

So this doctor at the ER, an older man, examined our boy and determined that he did not have a hernia. He demonstrated this by running a thumbnail up the boy's thigh, a reflex test that causes the testicles to automatically draw up; he said that this would have caused him extreme pain if there'd been a hernia. He also had the kid jump up and down. The boy had been coughing quite a lot and the doctor said he might have pulled a groin muscle from that.

Ever since then I've sort of been in favor of exclusively male doctors for exclusively male problems, despite the fact that I try to have an egalitarian attitude about medical caregivers. FWIW, when my old gynecologist, a man (whom I liked and was satisfied with) retired, and incidentally, turned his practice over to another guy who peopled his office with jerks, I chose a woman as my new gynecologist.