advice

[tamaith]

www.craigslist.org/about/best/sfo/301345524.html

hopefully this link works. if not google craigslist er doc. must read.

[Richard B the EMT]

Is this OUR ERDoc? Both seem not to mince words.

[tamaith]

no i don't think this is our er doc. I heard about this from a friend so googled craigslist and er doc . Im not sure where our er doc is from but it appears this one is from the san fran area.

[Kaisu]

I love this!

... now if someone would come up with advice for the pseudo seizure patient, it would make my day

[ERDoc]

It was not me. It was to eloquent to be mine. You have no idea how happy it makes me think that you guys thought of me when you read it though. Two of my nurses asked me the same thing. I've never been more proud.

[DwayneEMTP]

I love this!

... now if someone would come up with advice for the pseudo seizure patient, it would make my day

I'm guessing you mean fake seizure instead of pseudo, as, though an unlikely mistake for you to make, I for years thought that they were the same thing...

I get your point though. For some reason, out of all of the shit, the fake seizures had the power to irritate me more than just about anything..not sure why. Maybe because I'd only seen it used for manipulation...

Dwayne

[Kaisu]

I did mean fake, and I thought they are the same thing. I will research. Thank you Dwayne.

A few things I have noticed about the fake seizure...

No one has one of those alone. There is always some weird ass family dynamic at play. The fake seizure interrupts whatever dysfunction is currently playing out and forces the focus of attention on the "patient". Some of it is drug seeking for sure, but I have run on people with full Rxs of benzos having a fake seizure. It is actually kind of interesting. I have yet to come up with a satisfactory way of dealing with these people. The last thing I want to do is educate them on why I know it's a fake. I don't want to coach up their act for the next provider.

One of my favorite things to do is monitor them during the "seizure" getting a BP for sure. I tell them "I know this is hard for you, but try and keep your arm still so I can get a good number". 99/100 cooperate.

I then say "Your BP stayed stable, your heart rate did not budge, and your O2 sats were not affected. Disconcerting as these episodes are for you, I will be administering no medications." Usually they go to sleep.

[ERDoc]

As Dwayne says, there is a difference. You have to love the fake seizures though. We got a call on the radio from an ambulance who was transporting a "seizure" pt to us. They said they had already given him 2mg of Ativan IV and said, "He's telling us he's still seizing and needs more Ativan. Do you want us to push another 2mg?"

Uh, no. As soon as the pt heard us say no, he stopped "seizing" and went "unresponsive."

[Happiness]

I posted this on my FB and my friend called me asking "Why are you looking for drugs on Craigslist"

[HERBIE1]

"Fake" seizures. I love those- quite entertaining. My favorite is when they are "convulsing" on the floor, looking at me and telling me that they are having a seizure and need medication. I've had a couple actually try to generate some spittle, but then wipe their mouths when it starts to run down their chin. LOL

I generally tell them to be careful so they don't hit any furniture or hit their heads, and many of them actually do look around while they are "seizing" to make sure there are no chair or table legs within striking distance. I then tell them to let me know when they are finished so we can "treat" them and give them a ride to the ER. They get their taxi ride, I tell them we don't have the "right" medication for their "special" type of seizures, so they need to wait until they get to the ER.

There's no point in arguing with these folks or pointing out they are fooling nobody- they either want a free ride to the ER for a Rx refill, or they are drug seekers. Either way they won't quit until they get what they want.