Assault in hospital.

Sadly assaults both verbal and physical  are a common occurance in hospitals around the world. A recent survey in the NZMJ confirms the amazing prevelance. Nurses are more at risk than doctors as they spend more time in promixity to patients. With those working in psychiatry and in emergency departments being at the highest risk.

Despite these rates it seems to be an accepted part of the job that the odd patient will attempt to punch/hit/kick/spit on you or more commonly verbally abuse you for any number of reasons. In my experience it is very rare that a patient is prosecuted for their behaviour. Often colleagues are dissuaded from taking matters further even after being assaulted.

Perhaps a police liaison such as those being introduced at Blackburn hospital would make a change. Having the local constabulary visit the department and offering the patient the choice between settling down or visiting the cells has been almost universally effective in getting patients to comply with requested standards of behaviour.

The last word i will leave to Paul Quigley from Wellington Hospital ED:

“There are mentally ill patients, others are under the influence, and some people are just arseholes”

Refs:

NZMJ article http://journal.nzma.org.nz/journal/127-1394/6125/

Thoughts from mike ardargh http://www.stuff.co.nz/national/health/10074792/Hospital-staff-under-attack

Blackburn (WARNING Daily mail link) http://www.dailymail.co.uk/news/article-2591479/Hospital-A-amp-E-unit-gets-time-POLICE-station-patients-violent-abusive.html

 

Biting off more than you can chew.

After being very keen and kicking off with the #FOAMed question of the day I’ve realised that it takes more effort and time that I want to invest at the moment. So I’ll be moving back to more old style posts of cases, discussion of papers and publications.

Thanks to everyone who has been involved in the QOTD project.

 

 

FOAMed question of the day 66 #FOAMedQOTD

A drunk patient is admitted to your ED to “sober up”

His nurse suggests some IV fluids to help him.

How effective is fluid therapy for alcohol intoxication?

drunk

Answer

FOAMed question of the day 65 #FOAMedQOTD

What volume of fluid from thoracocentesis is associated with an increased risk of re-expansion pulmonary oedema?

 

Answer

FOAMed question of the day 64 #FOAMedQOTD

 Kernigs and Brudzinskis sign are both used to identify patients with meningeal irritation.

How sensitive are these signs for the diagnosis of meningitis?

Kernig