There is one absolute rule in Emergency Medicine which protects both the nurse and the patient...
...and it is this...
...any female patient presenting with abdominal pain who is between the ages of puberty and death is considered to be pregnant until proven otherwise.
And so it came to pass that on a snowy sunday evening I was taking a full history from a 15 year old who had told Shuffling Bob that she had 'really really really bad' tummy pain.
Now one of the problems of examining teenagers is that they always believe that they have a new, hitherto unrecognised or undiagnosable disease that will cause them TO DIE A HORRIBLE DEATH!!!
And that no one loves them!!!
And that they all have the world's highest pain thresholds and so this pain...tonight...this is the WORST pain anyone has ever ,-ever-, in the history of the world, ever experienced!!!
Anyway...here was 'Ms Purple Hair and Pierced Nose' sitting in my room with her mother...who looked like a WWF wrestler.
Shuffling Bob had dipped her urine and on the face of it she probably had a bladder infection.
He hadn't done a pregnancy test because we are required to get permission from the patient before we do that particular test.
"Right...so do you take any medicines on a daily basis for any reason, medical or otherwise?"
"Can I just check that you're not on the contraceptive pill? Just in case I need to give you antibiotics tonight?"
Oh...yerss...I'm on the Pill...
"Okay...are you actually sexually active?"
She blushed...I was surprised.
Sexually active!!! Sexually active!! , shrieked her mother.
She and her boyfriend are at it like rampant rabbits!!!
My patient blushed an even deeper shade of red.
They haven't stopped with the sex since she went on the pill...
My patient was now purple with embarrassment.
They're at it all the time , in every room of my house....they think I don't know...all the time...and we've got cable television as well !!
My patient looked like she was on fire.
"Right...good...well then...lets have a poke and prod and see whats going on..."
Two minutes later after a full and diligent examination of her abdomen I decided she did indeed have a simple and uncomplicated bladder infection.
"Okay...I'm going to give you some antibiotics...there is a possibility that your contraceptive pill will not work properly so use a barrier method of birth control for the rest of this cycle..."
Wot do you mean....barrier method...?
"Well...you should be in one room at your house..."
"...and your boyfriend should be in another room...preferably in his own house"
Her mother laughed....I wish I'd thought of that...little buggars, at it all the time!!!
A mothers love....'tis wondrous to behold.