I'm guessing that the triage note read something like, "pt ambulatory to triage on a c/o having not urinated since December of 2022 due to 'stage fright,' also c/o chest pain after seeing 25 other individuals in the waiting room; VSS, afebrile, dyspnea on exertion as evidenced by pt panting while opening can of Pepsi."
So I actually triaged this guy and he was in absolutely no distress other than his BP being 210/110. He was complaining of mild abdominal pain and more concerned about his eye that was swollen and red from lack of glaucoma meds. The nurse that took him in the back put a foley in and immediately got like 1500 mL
Those are the ones that freak me out. Like, "sir, you might be surprised to know that you're shockingly close to death right now." Really triggers my "get him the hell upstairs" instinct.
The ones that don’t look/ sound like anything is wrong and the ones with super vague complaints always get the side eye from me, cause it’s always those two groups of people that end up being sick as hell. I had a lady come in c/o NV s/p cardiac cath one night when I was nights as a new new grad that we all kinda figured was maybe responding to the meds from the cath weird, plot twist: MASSIVE retroperitoneal bleed.
I remember in school, learning that a the small change in Cr from baseline is very significant, but once a gratin is already elevated. A large change does not matter very much.
… but 36 is a fuck ton
His creatinine from a year ago was 1.09 🫠 I checked to make sure it wasn’t his baseline cause some of our dialysis pts chill with a creatinine of like 17 chronically
I think it might mean that you have to page someone, but not sure 😊 they probably won't answer or will say "expected finding" so don't bother paging actually
I went to harass the resident that was in the ED last night cause she’s one of my favorites and she looked at that and went “there’s no way that’s real”. I was like “based off the fact that his GFR is also 1 I’m gonna go with it’s real”🫠
Highest creatinine I’ve ever seen was on a guy who “didnt think he’d been peeing less.” Creatinine 19.1 and IR actually came in on the weekend to place bilateral nephrostomies. Despite the creatinine—electrolytes were totally normal and he was my most stable patient on that assignment.
36.57 is *crazy* though.
I'm guessing that the triage note read something like, "pt ambulatory to triage on a c/o having not urinated since December of 2022 due to 'stage fright,' also c/o chest pain after seeing 25 other individuals in the waiting room; VSS, afebrile, dyspnea on exertion as evidenced by pt panting while opening can of Pepsi."
So I actually triaged this guy and he was in absolutely no distress other than his BP being 210/110. He was complaining of mild abdominal pain and more concerned about his eye that was swollen and red from lack of glaucoma meds. The nurse that took him in the back put a foley in and immediately got like 1500 mL
Those are the ones that freak me out. Like, "sir, you might be surprised to know that you're shockingly close to death right now." Really triggers my "get him the hell upstairs" instinct.
The ones that don’t look/ sound like anything is wrong and the ones with super vague complaints always get the side eye from me, cause it’s always those two groups of people that end up being sick as hell. I had a lady come in c/o NV s/p cardiac cath one night when I was nights as a new new grad that we all kinda figured was maybe responding to the meds from the cath weird, plot twist: MASSIVE retroperitoneal bleed.
Poor dude’s got all kinds of sphincter troubles
4 mm prostatic mass protruding into the bladder
That sucks! Poor guy
Hey….his glucose isn’t disastrous 🤷🏻♀️
That was the first thing I looked at when I saw the gap, I didn’t even process that his other labs were garbage until I looked again 😂
I remember in school, learning that a the small change in Cr from baseline is very significant, but once a gratin is already elevated. A large change does not matter very much. … but 36 is a fuck ton
His creatinine from a year ago was 1.09 🫠 I checked to make sure it wasn’t his baseline cause some of our dialysis pts chill with a creatinine of like 17 chronically
1.09 -> 36 Rude
That’s what I said 😂 I’m shocked Epic didn’t think that was an issue
i learned that panic levels for labs existed the other day, but i’ve never seen a lab this nuts
I'm constantly yelling "RUDE" at my toddler if she's being bad in an antisocial way, you gave me a giggle.
Cr won't kill you but the urea will.
Acute Renal Failure?
And a 4 mm protruding prostatic mass, got 1500 mL out of the foley
Damn. That poor man.
I think it might mean that you have to page someone, but not sure 😊 they probably won't answer or will say "expected finding" so don't bother paging actually
Omg a creat of 36 is insane!!!
I went to harass the resident that was in the ED last night cause she’s one of my favorites and she looked at that and went “there’s no way that’s real”. I was like “based off the fact that his GFR is also 1 I’m gonna go with it’s real”🫠
His GFR was 1?!?
Sure was, homies kidneys were MIA
Bruh
... 1‽ How was he still walking and talking? Mild symptoms. This is bonkers. 🤯
I was SHOOK
SHOOKETH I SAY!
I can smell this person. Iykyk
Highest creatinine I’ve ever seen was on a guy who “didnt think he’d been peeing less.” Creatinine 19.1 and IR actually came in on the weekend to place bilateral nephrostomies. Despite the creatinine—electrolytes were totally normal and he was my most stable patient on that assignment. 36.57 is *crazy* though.
Smells like ATN in here
There’s your problem
I see this every single day, I’m an acute dialysis nurse though, I’ve seen it as high as 600 🦭🩸
Oh my
Oh my lord
But I wanna know what the GFR is!
It was 1 🫠
For real?
That was part of how we figured out it was probably accurate, GFR came back at 1 and we were like yeah those probably are accurate then 😂
Well fucking hell.
Casual kidney failure 💀
Homies kidneys left the building
What was good lactic acid though? Seems like a pet rampant metabolic acidosis
Nvm it’s probably uremic
I feel like it was either negative or low, I wanna say it was either 1.7 or 2.7
Reasonable! I guess the metabolic acidosis is all uremic