Emergency! The Nose Knows

All it took was a good sneeze. It was the sneeze that started a string of events and ended up making for good research.

While reading the newspaper Monday night — yup — I sneezed. My nose started to bleed which, when the heat is turned on in the house, happens on occasion. It usually stops bleeding in a matter of minutes and life goes on.

Except Monday night, it wouldn’t stop. I pinched my nose, one-handedly filled a ziplock with ice so I could use a cold compress… nuttin. Still bleeding. And I was home alone (husband travels for business — oh no!)

When I got out the second box of tissues, I realized that it just wasn’t going to stop as it should — and of course, I began to get very nervous. Finally, an hour later, I called my primary care’s phone number, and five minutes later, the doctor-on-call called back. His advice: dial 9-1-1.

So I did. They promised no lights or sirens and they didn’t use them. I propped open the front door and waited for the EMTs while standing over the kitchen sink, bleeding profusely — even through my eye! When they got there, they threw the blood pressure cuff on me and my usual normal no-problem blood pressure read 210 over 173. I was whisked into the ambulance and taken to the ER. At that point I was pretty much ready to pass out.

Fast forward four more hours and 3 IV attempts later. My nose stopped bleeding around 1:15 AM and they sent me home an hour later. Chalked it up to the membranes in my nose which had just cracked from the dryness and opened the blood vessel. The higher my blood pressure, the more profuse the bleeding. etc etc — I’ll leave the rest to your imagination. Needless to say, my clothes are pretty much a loss, too!

But what I learned about the ER! Certainly I had read plenty, and talked to other patients and their families about their experiences. But it had been at least 20 years since I’d been to the ER — and the lessons learned Monday night were invaluable.

So I’ll share a few with you. Who knows? Maybe someday they can help you:

~ Choose your hospital based on where you want to end up if you are admitted.  The EMTs may tell you about which hospitals are — or aren’t — accepting patients. There are four hospitals in Syracuse, and I was told only one of them had space, one I did NOT want to go to because I’ve heard too many stories about patient infections. I insisted on going to University Hospital, because I work with many of the people there. I was taken to University.  They told me that they are required to tell me which ERs are filled, but if I insisted, they could take me to my choice. I did, and they did.

~ Avoid arrival at the ER during the change of shift. The first group doesn’t want to deal with you because they want to go home (don’t blame them.) The second group needs to be briefed on the entire patient population before any of the doctors look in on you. I figure an hour of my time there was due to the shift change at 11 PM.

~ Have good veins. The EMTs blew out a vein in my arm (you should SEE the black and blue!) and did a lousy job on putting one in my hand. I asked for it to be removed (it hurt! and they weren’t using it for anything.) The ER nurse replaced it and did just fine because she was able to take her time and find a good vein.

~ Ask a LOT of questions and keep asking what will happen next. I found that when I asked how long it would be before someone checked in on me again, or when the doctor would take a look — anytime I stayed on top of things, they kept up with me. If I didn’t ask, it was much longer before anyone else looked in on me.

~ Keep asking people to wash their hands. I noticed the nurses were much better about that than the doctor was, but they all were willing to cooperate with me and none seemed surprised by my request.

~ Listen. Listen to everything. You’ll be amazed at what you learn. You’ll learn about your own body. You can hear comments about other personnel. You might hear music. I could hear a cleaning person with a good sense of humor. You can hear other patients talk to their loved ones, or the professionals. In my case, I was able to keep my own less-than-life-threatening situation in perspective. The man behind the curtain next to me probably didn’t make it through the night.

~ Keep your sense of humor. Personnel are more responsive when they know you’re nice to them and can be a little self-deprecating.

~ Make sure you follow all their directions when you leave. Compliance with instructions will keep that kind of visit from recurring.

Finally — there were all kinds of things I thought of later. Included were: always have someone else with you who can pay better attention, help to ask questions, and advocate for you. [My poor husband so wanted to be there. Had I been admitted (ha! for a nose bleed? I think not!) he would have returned home and he could have been there to help out.]

~ Ask for copies of any test results. They did blood work on me and I called yesterday (a day later) to request copies. I didn’t think to ask while I was there.

No doubt I’ll think of more. As I do, I’ll add them here.

The bottom line? I was grateful the folks were there to help. A nose bleed is really NO big deal but the staff did everything they could to help and now, 30 hours later, no recurrence. That’s all I can ask for.

There is NOTHING like first hand experience and now I’ve got it. If you can think of other ER hints to share with patients, please let me know!

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2 Responses to “Emergency! The Nose Knows”


  1. 1 Betsy Gardiner April 11, 2007 at 4:30 pm

    Trisha —
    It is amazing to what extent you will go to gather such valuable advice for your devoted readers! Thank you for doing the field work so that other patients can benefit from your very astute observations and words of wisdom!

    You did a great job of pointing out many excellent hints for being a smart ER patient. I have a couple of additional thoughts.

    Your point of having an “advocate” with you whenever possible cannot be stressed enough:
    ~ Ask the ER staff to call your relative, friend, or neighbor to see if they can come be with you. You may have not had time to do that when you were whisked away to the ER. You have the right to have someone with you at all times, although the doctor or nurse may ask them to step out momentarily for your privacy reasons.

    ~ Wash YOUR hands! You may have been sitting in the waiting room where many other people have been seated and used the armrests where you are sitting. Doctors often shake the patients hand when greeting them, so be aware of where your hands have been. Once you are discharged from the ER, wash your hands as soon as you can after leaving. If you are unable to give them a good washing (for as long as it takes to sing the ABC song!), be careful not to touch your mouth, eyes, or nose until you can wash.

    ~ Ask the ER doctor to talk to your own doctor if you would like them to consult with one another. Hopefully, your own doctor knows you well and can act as an expert for consultation. After you are discharged, always contact your own doctor and tell them what happened and arrange for a follow-up appointment for continuity of care. Take all lab test results with you or arrange for them to be sent directly from the ER to your doctor’s office.

    Despite the hazards that we need to protect ourselves from when in the emergency room, the ER is almost always the best place for us to be in times of a medical emergency. All of these and Trisha’s tips (and there are certainly more!) make it safer and a better experience for the patient.

    Thanks.

    Betsy Gardiner, RN
    Health and Patient Advocates

  2. 2 Trisha Torrey April 12, 2007 at 8:24 pm

    Betsy, What great additions to the list! Thanks so much for taking the time to post…. you’ve done a great service.

    Trisha


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