Saturday, June 26, 2021

June 26

We recently had a very drunk middle aged dude come in for an MVC, because of course he was shithoused, high, and driving extra fast. As people do. Anyway, he dislocated a hip out of socket and it was decided that we needed to do a conscious sedation after his CT scans to a) reduce his hip and b)shut him the fuck up because he was literally nonstop screaming at the top of his lungs. 

His belly was distended when he first came in to us so obviously we were concerned about internal bleeding, traumatic injuries, etc. After reviewing the CT though it turns out he was just gassy. Like, ALL the gas in his entire body was concentrated in his stomach. How that man wasn't constantly burping up stale beer air is beyond me. The trauma doc went from being super concerned about internal bleeding to very concerned about gastric rupture, in addition to his actual traumatic injuries. 

A belly full of gas + intoxication + sedative medication is just a beautiful recipe for aspiration, so before the conscious sedation could take place we needed to decompress his stomach. I was somehow the lucky one who got to drop the NG tube on a 250 lb screaming drunk idiot. There's no easy way to do these on a cooperative patient let alone a flailing one and also I hate doing them. But it was me, the patient, and about ten other people in the room waiting for me to place the tube so sneaking out wasn't an option.

I managed to easily get the NG tube down with holding help and a fair bit of luck, and OH MY GOD YOU GUYS. Normally we have to inject a bit of air and listen via stethoscope to confirm placement, but not this time. Oh, not this time. As soon as the tip of the tube got into his stomach, it was like one of those whoopie cushion cartoon farts. Air started rushing out of the tube so fast it was causing turbulence in the room. I started laughing. The trauma doc started laughing. The other nurses started laughing. The patient was not laughing, but you can't win 'em all.

The cartoon farty noise went on for at least thirty seconds. I was laughing so hard by the end of it that I had to leave the room to go wipe my eyes. I'm not lying when I say this is literally the funniest work moment of 2021. It's up there with the legendary pinkeye situation. Which also contained comedic flatus, so I think the moral of this story is that I'm a teenaged boy and farts are the funniest thing on the planet.

2 comments:

knittynurse said...

Bahahaha! That is completely and ridiculously hilarious. I love it.

Oldfoolrn said...

That's a good one. That patient sounds like an ideal candidate for NG tube bridling which will take the wind out of most every patient's sails. I think there is post about NG bridling on my blog somewhere.

For some of the more paranoid old school nurses, verifying the position of an NG tube by auscultation while injecting air was not enough. They would dip the end of the NG in a glass of water and ask the patient to pant. If there were zero bubbles the NG position was good. I betcha it would have been a hoot to try the air bubble test with your patient.