Wednesday, I had the pleasure (not) of being stuck in a chair at an ED for 7 hours. In the next cubicle sat a patient presenting with non-resolving boils. The young doctor did some lancing, then called the consultant to advise on treatment options. Consultant set out three possible treatment options for consideration and during the discussion of this the patient mumbled something near incoherent about MRSA. Further questioning brought out the information that it was ‘a bad one’. There was a flurry of phone calls to patient’s GP, and it transpired that the S. aureus was multiple drug resistant. There was also then some talk about “stopping earlier treatment because it wasn’t working”.
OK. The stupid bits? Why did the patient not alert the triage nurse to the MDRSA status? Patient might not have completely understood the implications, but should have mentioned it. Why did the doctors not suspect at least MRSA and have the patient’s status checked much earlier (like before lancing the boil, then moving on to examine immune-deficient me)?
At least, patient is unlikely to die. There is one treatment option available – oral something or other under close supervision.