'Probably Drunk'

EMS ambles in with a "probably drunk" patient around 4 a.m. They report finding this 70ish homeless man with mental health issues sitting on the sidewalk. The patient complained of a group of men coming upon him and kicking him in the butt.   I went to check him after he was settled in a room. To my shock, the supine gentleman was trying to pee in a urinal without success. I've seen plenty of guys peeing in the ED. My concern was that he was lying down. Anyone who has been in the ED for a period of time knows that drunk guys who are barely able to speak will still try to stand up to go. Even male hemiparetic stroke patients will fight to be upright to relieve themselves.   My mind started to race that this guy might need an MRI. Maybe he really was injured, and now had a cord compression. Even though he was still lying there with a urinal between his legs, I commanded him to lift his legs. He lifted only the left one. I repeated the order, and again he lifted only the left. My concern grew as I slapped the bottom of his right foot and insisted he tried to lift that one off the bed. He did it, but he was a little shaky.   What the heck? Is he drunk? Is his cord compromised? Does he have a brain injury? I asked if he could have hit his head, and he responded, "I've been stumbling for the past few days. I could have."   To the Doughnut of Truth for head, abdomen, and pelvis scans, which provided the answer:     He had an impressive subacute on chronic ...
Source: Lions and Tigers and Bears - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs