Med Glossary - Part 2
In this second part of the series, the chief complaint is:
"I spit up some blood"
This is a meaningless complaint; I never know what patients mean by this, so more questions are always necessary. Typically, it will be one of the following:
1) I coughed up some sputum with a little streak of blood on it, like a red thread lying on top of the phlegm.
2) I coughed up a mouthful of frank blood.
3) I vomited 10 times, and the last time there was a little streak of blood on top.
4) I vomited a bucketful of bright red blood . I'm feeling a little dizzy too.......
5) I vomited some brown liquid that might be blood. My "boo boo" has been dark this week too.
6) I had a nosebleed today, and I spit out some blood afterwards.
7) I have rotten teeth. When I spit, I noticed some blood in my saliva.
8) I want a work excuse.
"I spit up some blood"
This is a meaningless complaint; I never know what patients mean by this, so more questions are always necessary. Typically, it will be one of the following:
1) I coughed up some sputum with a little streak of blood on it, like a red thread lying on top of the phlegm.
2) I coughed up a mouthful of frank blood.
3) I vomited 10 times, and the last time there was a little streak of blood on top.
4) I vomited a bucketful of bright red blood . I'm feeling a little dizzy too.......
5) I vomited some brown liquid that might be blood. My "boo boo" has been dark this week too.
6) I had a nosebleed today, and I spit out some blood afterwards.
7) I have rotten teeth. When I spit, I noticed some blood in my saliva.
8) I want a work excuse.
posted by scalpel at 12:19 PM
8 Comments:
Reminds me of the Mexican guy Fire-Rescue brought in following a week long drinking binge. They said they almost didn't transport him because he wouldn't consent, I guess they missed the class that covered how a drunk and almost unconscious person can't refuse treatment, and as we wheeled him back he would spit frank blood on the walls. It was really fortunate that he didn't land a red loogie on another patient.
After a valiant effort, we saved him to drink another day.
"this blood, did you cough it up or throw it up?"
"i don't know."
"did it come from your stomach or lungs?"
"(shrugging)"
"did you do this (me hacking) or this (me retching)?"
"i think it was kind of both"
"(my head exploding)"
How common is Vomiking where you are at?? When I was practicing in LA and MS it was quite rampant. There is less of it in California, but it still exists.
Vomiking is almost as common as coughing up coal.
Aw yes, coal (cold?) I forgot about that one.
My patients down south would cough it up, spit it up, vomik it up, have it in their ear, stuck in their throat, caught in their lungs
One of my coworkers had to leave early a couple of weeks back. Her infant son was sick and her husband called in a panic because he was vomiting blood.
It turned out to have been the red medicine they'd been giving him.
Lovely concise breakdown of this frustratingly vague complaint. I will be teaching this to my residents once I'm an attending -- it's all too easy to jump to conclusions with this chief complaint.
And on the South Side of Chicago, even I find myself asking people if they're vomicking.
My mother had number 6 (which she relayed to me as "coughing up blood") once. I tried to tactfully suggest she went to her doctor the NEXT DAY (she has lived in a TB endemic area and my father has had TB in the past). I was both relieved and annoyed when she decided it was just a nosebleed.
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