Trust Once Lost

by Greenhorne

Supplemental: Patient Notes 1

*GREEN* (F)
MRN: 132719
Admitted: 12/5/04
Red Cross, M.D.

12/5/04 19:52
Unicorn Filly, name ukn, age ukn, assumed 8-10y/o, presenting to emergency with reduced LOC (GCS:9), lower RFL hematoma; gross deformity ?#, superficial cuts and bruises.

V:
Febrile 100.7F
HR 102
BP 97/42
sats 98% on RA
BGL: 4.3
Ht: 2’3”
Wt: 52lb

N:
Rousable to pain
Speech slurred and incoherent
Pupils 30mm, equal and reactive
Non-compliant with hoof grip assessment
Nil facial droop, good strength in all limbs

C:
EKG no anomalies
Peripheral pulses strong
Severe hematoma lower RFL
Capillary refill <1s
IVC in situ lower LFL; 80mL/hr NS; patent and secure

R:
RR 22
98% on RA
Regular and unlaboured
Lung sounds clear

GI:
All teeth intact
Bowel sounds normal
Nil distension or masses on abdo palpation
BNO
NBM

GU:
Has not voided
Bladder not distended on palpation
Nil external signs of sexual trauma

M:
Gross deformity ?# lower RFL
Muscle strength normal

I:
Multiple superficial lesions (see body chart)
Coat appears healthy
Nil signs of healed injuries
Skin hot and sweaty

P:
Ukn

Hx: witnesses report Green was found injured and unconscious in the Everfree Forest. Witnesses report Green became confused and disoriented upon waking. Witness states “she thought we were timberwolves” and reports that Green was initially resistant until she could be reoriented. Witness states that Green “limped about ten miles” before collapsing. Nil Medical Hx as patient is unidentified.

• CTB for urgent review
• CXR, RFLXR, Dental XR for age estimation
• CRP, CBC, EUC, LFT, Tox Screen, INR, XM
• Cath for Urine Sample, UA, UDS, UCx
• Place tracking spell for absconsion risk
• NBM for surgery
• For Ortho review
• For Neuro review
• For Social Worker review

Dr Red Cross, M.D.

Author's Note:

Glossary
LOC: Level Of Consciousness
GCS: Glascow Coma Scale (range 3-15, higher is better)
RFL: Right Foreleg
LFL: Left Foreleg
RHL: Right Hind Leg
LHL: Left Hind Leg
Hematoma: Internal bleeding
?: Query
#: Fracture
Febrile: Has a fever
HR: Heart Rate
BP: Blood Pressure
Sats: Blood oxygen saturation (above 95% is normal)
BGL: Blood Glucose Level (4-6 is normal, 5-10 is 'safe' for a diabetic; this is an oversimplification but we won't get into that here)
EKG: Electro Cardiogram
IVC: IntraVenous Canulla; an 'IV drip'
in situ: is currently in place
NS: Normal Saline
RR Respiration Rate
RA: Room Air
BNO: Bowels Not Open; has not defecated
NBM: Nil By Mouth; not allowed to eat or drink
Voided: Urinated
Palpation: Examination by touch
Lesion: part of an organ or tissue that has suffered damage; in this context refers to cuts, bruises, scrapes and scratches on the skin
Cath: Catheterise; in this case ordering the insertion of a urinary catheter.

Radiology Tests:
CTB: CT brain scan; a 3D xray image
CXR: Chest Xray
RFLXR: Right Foreleg Xray

Pathology Tests:
CRP: C-Reactive Protien
CBC: Complete Blood Count
EUC: Electrolytes, Urea, Creatinine
LFT: Liver Function Tests
Tox Screen: Toxicology Screen
INR: A clotting factor test
XM: Type and Cross Match (Blood Typing)
UA: Urinalysis
UDS: Urine Drug Screening
UCx: Urine culture (tests for bacterial infection)

Edited: v1.1

Comments

[nighters]

I wonder if she gonna have a magic surge since she never technically had one so it more dangerous?

[dustysculptures]

C: EKG no anomalies Peripheral pulses strong Severe hematoma lower RFL Capillary refill <1s IVC in situ lower LFL; 80mL/hr NS; patent and secure

Where you get cap refill on a horse idk. The frog I assume?

Pretty good thorough for a primary (as you'd except for a Jane doe) . Can't wait to see what comes outta this.

[Samellan]

Sounds exactly like a medical report. Good job!

[Legioner8]

Damn anamnesis.
I'm having flashbacks of my medical university days!

[Aurora the Void Dragon]

Ah familiar medical terminology, nicely done by the way.

[Greenhorne]

9958857
Are you going to comment like this for every chapter? Because that would be amazing!

Glad you're enjoying the story.

[Midknight Defender]

9958902
If it doesn't irk you, I'll comment however the whim of the moment takes me!

[Greenhorne]

9958940
Please do, I love having feedback.

[Greenhorne]

9958943

[Greenhorne]

9958940
If you're onto this chapter I take it nothing noteworthy happened in 'Self-incrimination', lol.

[Midknight Defender]

9959018
Nope, I saw your comment and responded before going to dinner. I haven't finished that one yet.

[Greenhorne]

9959091

But you won't be writing your name in the snow ever again, huh?

Still possible, but it requires more athletic ability.

[Midknight Defender]

9959101

The mental vignette that calls up is either the most terrified case of stage fright an Olympic gymnast has had mid-routine, ever, or something that belongs buried in the closet at the back of the NSFW section of a boarded up Blockbuster Video... that's haunted by the ghosts of the cast of Queen of the Damned.

Thanks for that.

[Greenhorne]

9959119
I mean, I was just imagining them demonstrating why cursive is sometimes called running writing, but your way works too I guess.

[NetherWalker]

9959119
Alright, that is amazing. The lengths you went to describe that were above and beyond, and for that Sir, I salute you with all the enthusiasm my tiny arm can muster. Godspeed you magnificent bastard!

[LucarioFan2066]

[ferret]

lower RFL hematoma; gross deformity ?#,

That semicolon should probably be a colon. Semicolons are "high priority commas" in comma expressions, to allow you to have lists of lists. i.e. "Nearby landmarks included an old, tall tree; a pile of large, stone boulders; and a wide, rushing river." So using a semicolon there, it looks like "lower RFL hematoma" is the ending of a comma expression, and "gross deformity" is the beginning of a completely unrelated one.

TBF, most people shouldn't use semicolons at all because they're confusing and not well known; plus maybe that's just convention for nurse shorthand. All I know is the function of semicolons in general, as "that thingy in between a comma and a period"

[Silentwoodfire]

Should we be concerned that it says thers a lung (and not lungs)

[Crystal_Frost]

If this is how doctors take notes know wonder people say doctors have there own language hehe

[Black--Soul]

Well she is in very bad shape but could be in better hoofs to care

[Black--Soul]

R: RR 22 98% on RA Regular and unlaboured Lung sounds clear

Lungs

[Dragonin]

Ah, so they are either going to assume abuse was done by someone who is really skilled with healing Magic, or that something is rotten in Denmark?
Apparent nerve damage noted.

[tsaukpaetra]

All in all, not bad at all!

[Detsella Morningdew]

I absolutely love this.

A medical professional is not in the usual demographic for Fimfiction writers, so it's great to see someone who can write medical elements with more than a vague understanding of events.

[DF]

Capillary refill <1s

I actually know what this means and how to test it. One of the few I understood before reading the glossary.

CT brain scan

That will be interesting.

[Luckyfanisaac]

C: EKG no anomalies Peripheral pulses strong Severe hematoma lower RFL Capillary refill <1s IVC in situ lower LFL; 80mL/hr NS; patent and secure

How would you explain the anomaly’s on my OC?
images-wixmp-ed30a86b8c4ca887773594c2.wixmp.com/f/26d87f87-4f9c-4c2a-b276-8c4e7a94512f/da89nh5-ecd1a77f-a8d0-48e4-835f-4b4aebf8b74e.gif?token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJzdWIiOiJ1cm46YXBwOjdlMGQxODg5ODIyNjQzNzNhNWYwZDQxNWVhMGQyNmUwIiwiaXNzIjoidXJuOmFwcDo3ZTBkMTg4OTgyMjY0MzczYTVmMGQ0MTVlYTBkMjZlMCIsIm9iaiI6W1t7InBhdGgiOiJcL2ZcLzI2ZDg3Zjg3LTRmOWMtNGMyYS1iMjc2LThjNGU3YTk0NTEyZlwvZGE4OW5oNS1lY2QxYTc3Zi1hOGQwLTQ4ZTQtODM1Zi00YjRhZWJmOGI3NGUuZ2lmIn1dXSwiYXVkIjpbInVybjpzZXJ2aWNlOmZpbGUuZG93bmxvYWQiXX0.oQMn81kvWv9S6Tb5VZRlZFYW93yDtoLZA6YIc7BvOoc

[tsaukpaetra]

10106733
EKG: Unreadable, severe hypovolemia, possible hemochromatosis from accoutrements, requires more pylons.

[ChronoMitsurugi]

10106733
I dont know why you are being downvoted. *snrt* i genuinely *chuckle* want to know as well.

[Black--Soul]

Re-reading atm... Love this story and its details ♡
A rare treat indeed

[Arxsys]

Huh, I’ve never seen NBM, always NPO. Same difference though. Solid work on the medical jargon though.

[Orthoros]

• For Ortho review

Aight I'll take a look, but I can't promise anything, I'm a chef, not a doctor.

[Greenhorne]

10728999
derpicdn.net/img/view/2018/7/29/1792442.png

[FOXTrot2]

I heckin' love technical stuff like this.

[FOXTrot2]

10106733
I'd explain them as Time Lord syndrome, and that that's for a different office.

[Jack-Pony]

Please, pls no. No more patient reports. I am not a 'trained'- FUCK I technically AM trained now. The joys of going from a PCA to a Home Provider. I read this out and KNEW what it said, until the ordered tests part. I has a sad nao.
Very nice. 10/10 makes me remember I have monthly reports due soon.

[ARandomLonelyDude]

10106733
I think that your OC needs to undergo blood letting.

[shinybob606]

So the glossary helps but can you explain all the header parts ( V: N: C: M: etc)

[LeCo177]

‚presenting to the emergency room‘

I immediately had to think of ChubbyEmu aka Dr. Benard right there.

[darklight731]

Thank you for this mister professional doctor person.