Another patient tonight with PV bleeding. She is meant to be pregnant, self diagnosed with a urine pregnancy test at home. Couple of weird things in this case:

1) Her quantitative BhCG today was <1, non-detectable. Even for a missed miscarriage, this is a bit unusual.

2) She claims that her blood group is B-ve. We thought she would need some anti-D. Today's blood group and hold revealed: B+ve.

3) She also claims that she delivered her three children at Southern Health - 1 at Dandenong and 2 at MMC. No records of this on our system at all.

In the end, the patient discharged herself against medical advice because her kids were crying and her husband has to go to work tomorrow morning.

Something strange...

Patient presented tonight with his girlfriend. The couple were having sex this morning when the boy experienced sudden onset of penile pain and they noticed large amounts of PV bleeding from the girl. The boy withdrew and discovered he had a tear on his penis at the attachment of his foreskin - the source of the pain and blood.

So, the large amounts of PV blood...bleeding from him? Or bleeding from her?

Haven't written anything in ages...job applications and ED have kept me so busy T.T And it's such a shame because I've seen so many interesting things that I haven't had time to reflect upon...

Ever wonder how likely patients are going to survive when we ship them out of ED? Last week I heard the phrase "this patient is going to Gen Med for a trial of life". The poor lady was being admitted for IV anibiotics in a last ditch attempt to treat her raging pneumonia. "Trial of life" is a common phrase used in ED, but probably reflects how stark the reality is for these patients. To these patients, the hope of surviving this admission is probably close to zero...and yet doctors still try. Perseverence or stupidity? I guess we just do whatever the family wants...