Just when I thought I'd seen it all, along comes another hospitalist experience that gives me a double take. She was a 30 year old black female texting in the ER right in the middle of her status asthmaticus attack (not to be confused with status hispanicus). Status asthmaticus is a severe form of asthma with findings that require continuous monitoring for progression to respiratory demise. This lady was on BiPAP, a form of external breathing support that helps people in respiratory distress to try and overcome their illness without ending up intubated. She showed all the findings of impending respiratory failure from her status asthmaticus:
- Diffuse wheezing
- Poor expiratory air flow
- Accessory muscle usage
- Hypercapnea
- Tachypnea
- Tachycardia
- Prior history of being on a ventilator
She had all these poor prognostic signs. All except one. She couldn't get her eyes off her brand new iPhone 4
long enough to stop texting. Maybe in her mind, this was her Last Supper. Here's a lady who appeared to be minutes away from ending up on a respiratory and she was too busy texing to take her eyes off her phone and answer some questions for me.
long enough to stop texting. Maybe in her mind, this was her Last Supper. Here's a lady who appeared to be minutes away from ending up on a respiratory and she was too busy texing to take her eyes off her phone and answer some questions for me. In retrospect, I think it may have been the smartest thing she did that night. With all signs pointing to intubation, her texting rampage in the ER was a sign she just wasn't as sick as she objectively appeared.
If you're a student or a resident, it's time to learn these other great medical signs:
- Handsome Sign
- Sleeping Husband sign
- O and Q sign
- Twenty sign
- MFer sign
- How to find a lost cell phone in the hospital: Happy's honesty sign
- Band-Aid sign
- Intact Humor Reflex sign
- Fibromyallergia sign
- Denture Stains sign
- Square Root sign
- And while you're at it, check out these funny homeless signs.
You can't learn this stuff in a medical school education You have to come to The Happy Hospitalist to make the leap to great bedside history and physical examination.
Go here to learn more about texting in the hospital.
Go here to learn more about texting in the hospital.
