Saturday, March 7 evaluate the abd pain/shock...

I mentioned in a previous post how certain days on the ambulance have a theme or recurring chief complaint. They rarely have the same cause, usually it is as a result of some story on the news. (Don't get me started about the whole peanut butter thing)
Our previous patient had yet to vomit and had one occurance of diarrhea and demanded an ambulance to the hospital.
An hour later we responded to the college dorm/assisted living building and met our new friend we later dubbed "The ABD Pain Princess."


A girl has called 911 stating her roommate is vomiting and feels weak.


Tired and expecting something similar to what we had earlier we're off to an upper floor, where we know it is mostly the college kids.
After repeatedly banging on the door we're finally met by a young college girl in her pajamas, looking quite healthy.
"It's my friend." As she slowly opens the door, here comes our 'patient' down the hall: Pajamas almost skin tight, giant fuzzy slippers, hair in a tossle and her oversized bag over her arm.

"I have food poisoning." She whispers, suddenly with a look of dispair on her face.
Almost like it was scripted we both ask, in unison, "Since when?"
We're so tired that fact isn't noticed until later in the shift.
"Since dinner around 10. I feel so sick." That was only 4 hours ago.
"Have you thrown up a lot?" My brain is on autopilot.
"Some, it's gross." She's distracted by something in her bag.
"Most vomit is. Did you notice anything...unusual in your vomit?" A standard question in my mind, I need to evaluate the extent of possible GI issues, right?
"That's disgusting! Do they pay you to look at people's puke? What a shitty job." Her voice is starting to remind me of Alicia Silverstone in that "Clueless" movie. There's a hint of entitlement in her voice and an undertone of priveledge, as if no one ever questions her judgment.
"Well, this job has its ups and downs. Speaking of downs, do you want to goto the hospital or try to get some rest and fluids, possibly following up at the clinic in the morning?" Usually this is met with a frown and an affirmative to the ambulance. Not our princess.

"Why else would I call you. You're asupposed to take me to a doctor so I can get a shot or something. My mother would tell you that." She's rifling through her bag for something as I motion towards the hallway elevator.
"Well, let's go then. Is your mom here to come with us or give you a ride home in an hour when they release you from the hospital?"
"Oh, I'll stay a bit longer, it's OK, we have really good insurance." She says with a tone that infers I should have known that already.

Groan. Another 'insurance' call. I wish these insurance companies had their own ambulances, then they'd be able to remind these people what an emergency really is.

Into the elevator for the ride down and she's found what she was looking for in her purse.

Lip balm.

I don't know about you but when I'm feeling sick to my stomach the LAST thing I want is something flavored on my lips.

Not a peep from her the whole way in. I was amazed she didn't pull out her phone and start texting or something. Incase you're wondering, her vitals were textbook perfect, didn't have to Jedi them or anything.

Luckily the triage nurse knew me and saw the look on my face as we came in. After the vitals checked out we were instructed to "Put her in line with the others," out in the waiting room.
"But I need to be seen now!" she protested.
We left, silent.

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