SHORTSTORIES

THE MAJOR ALARM THAT TURNED OUT TO BE FALSE...MOSTLY Sometimes in these cases the patient is absolutely c razy with panic and pain, and everyone withina hundred yards knows it. This particular time was different.

I was the triage nurse and it wasn’t the patient freaking out, but her father certainly did, and so did our staff.

I was standing in front of the ambulance entrance late one summer evening when a father ran in shouting for help, cradling his silent and bloody 4-year-old daughter. She was wrapped in a formerly white sheet that was very nearly dripping with blood. Her face was covered and I absolutely did not want to be the person who unwrapped her.

However, I was the triage nurse, after all, so I stepped forward with my arms extended, and he quickly placed her in my arms. I turned and ran toward the nearest trau- ma room. I was met by staff from every department—respiratory, lab, x-ray, and still more nurses and doctors. We rapidly removed the sheet and the nurses had a wash basin ready.

She had run through an old glass door and had lacerations from head to toe. She was saturated with antibacterial soap and water and wiped down so we could see exactly where the problems were, remove the glass shards, and assess what was happening and what we needed to do. As we washed, then held pressure, the wounds began to stop bleeding. By this time she had an IV catheter infusing saline, and respiratory placed an oxygen face mask on her tiny face. She never even cried, she just looked scared.

Within twenty minutes, there was no overt evidence of any cuts that had been bleeding. We were stunned, and turned her side to side, searching for bleeding, but everything was completely controlled. I would almost say it was a letdown, but we were so incredibly relieved that nothing could be further from the truth.

It was absolutely incredible that all of the wounds stopped bleeding. There was not one laceration that required stitching. Not a single laceration that would leave a permanent scar.

After an hour or two, she was released to return home with her father. Incredibly, a little girl who looked like she was going to break everyone’s heart had improved to the point where the only visible problem was a slightly oozing scratch here and there. But it was nothing. But how it had made us all jump into action!

In this case the patient did not freak out, but all the staff certainly did. Amazing what a bloody sheet can make a person imagine. A discharge she was definitely much less scary on the way home than when she had arrived in the ER in such a flurry earlier!

WHAT IS BRAIN FREEZE?

Let’s tackle this topic just in case it gets hot this summer and we need relief from slushies and ice cream.

If you happen to be uninitiated, a brain freeze, sometimes called an ice cream headache, occurs when that ice cold summer treat hits the palate and sudden pain radiates up through the skull and sinuses. It’s harmless, and the pain usually lasts only a few seconds, but they are not pleasant seconds.

The apparent irony of brain freeze is that the brain cannot feel pain, which always originates from sensory nerve fibers called nociceptors (no-sih-SEP-ters) located all over the body. There are exactly zero nociceptors in the brain, which is why some patients can be wide awake during brain surgery.

So why do we have any headaches, including ice cream headaches? The protective shield around the brain has nociceptors aplenty. When the nerves in the palate are suddenly shocked out of their nearly 100° normalcy by something ice cold, they send out an alert, causing arteries and blood vessels to react. Doctors sometimes say the pain is “referred” or transmitted to a specific area, like the forehead. The same nociceptors can register pain when no icy summer treat is involved, but unfortunately for headache sufferers, those reasons are not fully understood. It is a fact, however, that people who suffer from migraines are usually more prone to cold headaches.

There are strategies to prevent brain freeze, and to cut it short when it does happen.

Step 1 of brain freeze prevention (assuming we’re going to keep eating ice cream) is to eat cold stuff slowly. A good start would be a half-teaspoon of ice cream. Ease into it so your nerves are not suddenly jolted into DefCon-3. Keep taking small bites or sips, and take your time doing so. Letting those small bites warm up near the front of the mouth helps too, since the freeze triggering nerves are farther back.

If a cold headache strikes anyway, some people get relief by pressing their tongue against the roof of their mouth. Another option to try is drinking something warm as soon as you feel brain freeze coming on, alternating the icy with some warmth to interrupt the pain signals.

Maybe someday no one will scream for ice cream. Correction: from ice cream.