neurological deficit. The alcohol made the teenager extremely sluggish to any response and his pupils were like large black buttons, slow to constrict to any light when his eyelids were forced open. The intravenous fluids the paramedics had administered had diluted the effects of the alcohol somewhat and he was responding by moving away from painful stimuli. This meant his airway was less at risk and he didn’t need to be intubated. The teenager made no attempt to spit out the Geudel airway and he was laid on his side just in case he vomited. I checked his pockets for a wallet or a phone as the friends wouldn’t give any information to the paramedics at the scene. I found a debit card with his name on it and a mobile phone with Mum and Dad programmed into the memory. I called them from the hospital phone and delicately asked if they had a son whose name was on the debt card. They were devastated that their son had ended up in the emergency department on a Friday night when he should have been at a friend’s house. They came into emergency within half an hour. The well-dressed couple were really angry that their son was taking up our precious time, treating his self-inflicted drunkenness rather than treating people who were really injured. The parents wanted to get him home quickly and were highly embarrassed that their family member had needed non-emergency treatment. They asked how they could help get him home and off my hands. The doctor had checked over this sleeping teenager and suggested we give him an antiemetic drug so he didn’t vomit again and another litre bag of fluid. His parents took it upon themselves to nudge him and pinch him and shout at him to encourage him to wake up. They were even pulling the hairs out of his legs to get him to wake up. After an hour, the teenager started to rouse and was able to slur some words together. His dad was so annoyed he got his mobile phone out and took a picture of his son lying in a hospital bed, drunk at the age of thirteen. The bag of fluid had finished and I capped his cannula and removed the fluid line. Once I disposed of this, I did another neurological assessment and suggested that he start to walk around and get some fresh air rather than being curled up under the hospital blankets. His parents were keen to get him home and agreed to assist him to mobilise. I put down the cot sides of the emergency trolley and allowed them to take control. The next moment there was noise coming as the trolley moved under great weight. He was up and on his feet, wobbling on each leg with one parent under each arm holding him up. His parents held the boy under each arm and were more or less dragging him up and down the corridor in front of the nurse’s station. The teenager was making slow progress lifting his legs for each step, but after several lengths and being forced to drink several cups of water, he was more awake. Luckily, he didn’t vomit any further and had enough fluids administered to potentially reduce his headache the next day. I removed his cannula and held pressure on his arm for a good three minutes as his alcohol-thinned blood wouldn’t clot as easily as normal. After advising his parents to let him sleep on his side and check on him every hour, he was discharged into the care of his embarrassed parents. I would have loved to be a fly on the wall at his house the next day. I hoped he wouldn’t vomit in the car on the way home. The joys of having children!
Butcher’s Knife It is always with foreboding when you see a butcher at the triage desk. It’s always a bit of a shock when you see knife injuries, even if you are expecting them to be bad. Usually wearing the blue and white striped uniform and the long white apron; well, it’s never any good when you see a large amount of blood poured down the white apron and a towel wrapped around his hand. On one such occasion, a butcher waddled into emergency trying to apply pressure