Warning signs are commonplace. Most of them are appropriate and provide information that is worth heeding. Part of the upcoming revolution in medicine is the computerized patient medical chart, most often known as the Electronic Medical Record or EMR for short.
The hospital I work for took the plunge into EMR in 1998, when the software was still very much in its infancy. Twelve years later, along with dozens of upgrades and new version rollouts, our EMR is state of the art and has vastly reduced the amount of paper we used to use in our patient charts. The savings, easily, is in the range of one-half to maybe even two-thirds. It also assists in preventing medical errors that can harm our patients.
For all the advantages the EMR provides to the clinicians and the patients, this post is not really about what the EMR can do. It’s about one feature of the EMR: the Alert Box.
Alert Boxes are automated pop-windows that contain information such as the patient’s drug or food allergies, drug interaction warnings, implanted medical devices like pacemakers, insulin infusion pumps and a host of other things related to the safety of the patient and reminders to the clinicians. The alert boxes often look like this:
These pop-up windows are an important and sometimes vital tool to protect patients and to alert doctors to critical information that will assist in their treatment of that person.
They are also boring.
With a diagnosis like that, Dr. Waggoner believes a presecription for proper treatment is in order to avoid the reader succumbing to a case of terminalis bordomitis. So, here, in no particular order is his contribution to the funny bone of medicine:
Alert Messages We’d Really Like to See…
Glossary: pt= patient, dx=diagnosis, p.o.=by mouth, i.m.=a shot injection, NEJM=New England Journal of Medicine.
Warning: Patient has a terminal dx: Stage 4 Bewilderment
Warning: Face mask with shield required for this pt with dementia when administering p.o. meds. Pt was 5 time national watermelon seed spitting champion.
Warning: Pt has dx of hemera antidiatithemamitis. Provide instructions unaccordingly. (Challenge: try to translate the illness)
Warning: Pt practices ancient art of hirsute armpit braiding. Dx: lice.
Warning: Pt has dx of schizophrenia with persistent delusions that he is a starfish because he has five appendages. Will only move when placed face-forward in contact with wall or floor.
Warning: Pt requires a sitter. Pt made a bomb out of a nitrile glove filled with alcohol gel hand cleaner and flushed it down the toilet.
Warning: Pt thinks physicians are manifestations of Satan because she claims somewhere in the Bible Lucifer appears dressed in white.
Warning: Pt believes that all medications given I.M. contain nanobots that broadcast his thoughts to the NSA.
Warning: Pt has an addiction to genealogies and will babble incessantly about the origins of your family name during the exam.
Warning: Pt has a small semiautomatic 9mm handgun (loaded) strapped to her inner thigh and if you ask her to remove it she will claim you are violating her constitutional rights to bear arms.
Warning: Pt will insist on explaining the meaning of each of his 87 tattoos before letting you treat him. Note: Be sure to act very interested in the ones on both of his knee caps. Pt agitates easily.
Warning: Pt will come with his copy of the complete works of Paracelsus and look up everything you do and diagnose to check if you’re right. Note: Be sure to brush up on the Harmonies before the pt visit.
Warning: Pt is a prospector. Will only pay in gold dust.
Warning: Pt will quote passages from the NEJM contradicting everything you say.
Warning: Pt ingests Mentoes and Diet Coke just prior to exam.
Warning: Pt has an implanted IPod. Push right nipple to change tracks; twist left nipple to adjust volume. Upload port located in right nostril diguised as a piercing, Just pull to extend for easy connection.
Warning: Pt is hyper-patriotic. Carries a flag wherever he goes. Will insist the two of you stand at attention and recite the Pledge of Allegiance before beginning the exam.
Warning: Pt has a prostate exam fetish.
Warning: Pt has the Declaration of Independence tattooed on his right ear drum. Will ask for a $20 donation to look at it.
Warning: This pt will only speak through a sock puppet on each hand. Talk only to the one on the left hand. The one on the right cusses like an old longshoreman.
Warning: Pt has carved the nail of his right big toe into a train whistle which he will insist on demonstrating all of the crossing codes.
Warning: Pt had a silicon cast of her head made, which she carrys with her at all times and talks to before she makes any decision.
Warning: Pt believes she channels Jessica Rabbit.
Any other warning messages come to mind? Feel free to post yours in the comments (please keep them in the G and PG-13 rating range).