Bettering Plainfield with the facts since 2005

Friday, October 5, 2018

Dan's excellent (if somewhat gory) adventure at the Muhlenberg Campus ER

No treatment without a patient ID wrist bracelet.

This is a somewhat gory story, so if that's bothersome you should just pass this one by.

When I needed to go on dialysis, the first medical step, taken at JFK back in late March, was to insert catheters in my chest to allow for hooking up to the dialysis machine.

For most patients, these are only meant to be temporary (though there are a few who have been on them for years), and are removed after an operation on their arm to link a small artery and a vein for the infusion needles. (That was the surgery I reported on last summer.)

That joining of an artery and a vein is called a fistula, and once a patient's body adjusts to the infusion taking place through it, the catheters are removed.

And that was what happened Thursday morning when I showed up at the office of my vascular surgeon, Dr. David Richmond. (Great guy, turns out he's known by many medical people and Plainfield folks for his many years of excellent care.)

So, Dr. Richmond injects me with a serious local anesthetic and I am numb within seconds -- a numbness that lasted for hours.

Then he tugs and pulls to remove the two catheters (one to an artery, one to a vein) and after a few minutes says, "That's it." Done. He wipes away some blood and he and the nurse apply a dressing. Over.

The nurse secures the dressing with tape and tells me to sit in the waiting room for five minutes to make sure there is no seepage.

I waited ten minutes, just to be sure, and she gave me the green light after peeking down my shirt to make sure the dressing was dry.

And so things remained all day long.

I lay down for a nap about 5:00 PM and was awakened about 6:30 PM with a sensation of wetness.

My dressing was saturated with blood and it had trickled down my side onto the bed. And it was clearly not stopping. Every time I wiped it up, within seconds there would be a trickle out from under the dressing and down my side.

I got up and fetched a batch of 4x4 sponges and some tape and went into the bathroom. There I took off the bloody dressing and washed myself down. I could see the two minor punctures from which the blood was flowing and jerry-rigged a new dressing by watching myself through the bathroom mirror (try doing that sometime!).

It was a mess, and clearly wasn't going to do the trick. By this time, Nat had gotten home and applied another -- and better -- dressing. The bleeding continued.

So, choosing a shirt I didn't mind throwing in the trash, I drive myself to the ER on the Muhlenberg Campus of JFK.

In all my 35 years in Plainfield, I had been in Muhlenberg visiting friends and taking people to the ER, but I had never been in the new Satellite Emergency Department (SED).

I park in the lot and enter, only to be faced with a blank wall. A security officer is sitting behind a glass window and I say to him, "I need help."

He jumped up and came out into the entry and asked if I needed a wheelchair. "No," I said, "just where do I go?"

He pointed me down a hall where the admissions counter was at the end.

The nurse behind the counter briskly walked me through the routine. As a JFK patient, I was on the computer -- but without any medical history. After asking why I was there and seeing no obvious bleeding (yet), she went into intake mode.

She quickly went through the intake: medical history, meds, height, weight, contact numbers, medical directive, etc.

I was then shown into a curtained alcove (no "rooms") and told someone would be right with me. Two nurses arrived and one checked my vitals while the other took my insurance cards and led me through the five necessary electronic signatures to allow for treatment.

Then up onto the bed. After making me comfortable and draping me with a small absorbent plastic-backed sheet (reminded me of an adult diaper), they departed, saying the doctor would be right in.

Sure enough, within a minute or two, a 60ish doctor appeared. He pulled up a corner of the dressing, assessed the situation briefly and announced that he would put in a couple of stitches to close up the holes through which the blood was pouring.

The nurse set out a tray of instruments and dressing materials. The doctor gave me a few shots of a novocaine-like local anesthetic and within minutes the stitches were in.

While he was working, I made small talk by asking if he liked ER medicine. "Yes," he said, "I've been doing it for thirty years." He works most of the time at JFK, but all the ER doctors rotate to the Plainfield SED every so often and then go back to JFK.

Leaving the nurse to clean me up and apply the dressing, the doctor went out to print out my discharge instructions.

Reappearing in a few moments, he handed me a copy for my signature and I was on my way.

All told, I was there probably thirty minutes at most. Very well organized, calm, professional but pleasant experience.

The bays on either side of me had fresh occupants as I was beginning to leave and I had the sense the hum of the place was increasing.

As I passed the intake desk, I noticed the shifts had changed and there was a fresh crew. I stopped to chat for a second and complimented them on the entire experience -- to which they reacted with great surprise. Evidently, no one ever says "Thank you."

I hope that is not a sign of the times.

The SED is not equipped for serious problems (I was told if the bleeding started again not to come back, but to go to the JFK ER), but you should feel confident that you will be well cared for with minor issues -- and with more serious ones that they will stabilize you before you are transported to JFK.

Kudos to the SED staff!

End of gory story.

 -- Dan Damon [ follow ]

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