Springing from the bed

I was in the middle of seeing a patient and my attending grabs me and says that I should go drain the paronychia on a prisoners thumb right away. This is directly after there is shouting and he has jumped onto the floor handcuffed to the bed yelling at a corrections officer.

So I went in there and did the I&D of a thumb paronychia without incident except him yelling at the officer from time to time.

Then I found out the real reason he was here is because he had seized but was therapeutic on his meds. He was hyponatremic but was refusing IV access and had ripped out his first catheter.

It took some doing to explain to him what sodium is and that his was low and this is dangerous. He never really grasped it. So my job for a while ended up being to try to transfer him to Bellevue for further investigation. They finally accepted him after I had gotten an IV and started IV NS bolus on him.