- Email: [email protected]
Blue jean hands syndrome
CORRESPONDENCE
A study was undertaken to determine the preferences of a patient population presenting to the emergency department of a community teaching hospital. During the initial intake procedures, the clerk asked patients two questions: i) Would you rather be addressed by your first name or last name by the nurses caring for you? 2) Would you rather be addressed by your first name or last name by the physicians caring for you? Two hundred fifty patients answered these questions during an eight-day period. These 250 patients comprised 24.4% of all patients seen during that time period. Inclusion or lack of inclusion in the study was more or less random, being decided primarily by which intake processor happened to care for a given patient. Of the 250 patients, 200 (80%) preferred to be called by their first names, 46 I18.4%) had no preference, and 4 patients (1.6%1 preferred to be called by their last names. Of the 250 patients, all but one had the same preference regarding nurses and physicians. These data did not vary with age. Looking at patients aged 50 years or older, the respective numbers were 44 (81.5%), 9 (16.7%), and 1 (1.8%). This study seems to reinforce Heller's conclusions, and
the data are remarkably similar to those he collected. Expectations in this matter certainly do vary considerably. We were struck by the frequency with which patients volunteered comments such as "I like the intimacy of being called by my first name," or "[being called by my] last name is cold," although one patient echoed Natkins's sentiments, asking "Can we call doctors by their first names?" It appears that, at least in this population, most patients prefer to be addressed by their first names by the physicians and nurses caring for them.
Robert A Rosen, MD Berkshire Medical Center Pittsfield, Massachusetts 1. Natkins L: "Hi, Lucille, this is Dr Gold!" lAMA 1982;247: 2415. 2. Cunningham J: Use of first names. JAMA 1982;248:1708. 3. Conant E: Addressing patients by their first names. N Engi J Med 1983;308:226. 4. Heller M: Addressing patients by their first names. N Engl J Med 1983;308:1107.
Blue Jean Hands Syndrome To the Editor: A recent case of interest that baffled our emergency department staff for more than an hour before diagnosis was that of a 22-year-old woman who was previously healthy and who presented with a chief complaint of "blue hands." This was noted four hours prior to her visit. The patient had been sitting in a language classroom all day and denied immersing her hands in dyes or paint. She was a nonsmoker and denied taking any drugs. Examination revealed an anxious woman with a light bluish hue to the dorsum of both hands. The hands were warm to touch and nontender, with normal capillary refill. The remainder of the examination was within normal limits. During the course of her evaluation the patient was noted to be sitting on her hands. She was wearing blue jeans. On closer examination, and with the use of an alcohol pad, it was determined that the patient's blue hands were the result of sitting on her hands while wearing recently put-
chased blue jeans. We propose that this previously unreported condition which may present to an emergency department be coined "Blue Jean Hands Syndrome." [The contents of this letter are the opinions and assertions of the authors, and are not to be construed as official or as reflecting the views of the Department of the A r m y or the Department of Defense.]
Carson R Harris, CPT, M C Associate Director. Emergency Medicine Service Daniel Evans, PAS Cornelio Mariano, MC Silas B Hays A r m y C o m m u n i t y Hospital Fort Ord, California
[Editor's note: Another point to be considered is not sitting on your hands.]
A Multipurpose Resuscitation Catheter To the Editor: In the letter by Redmond describing a multipurpose resuscitation catheter (February 1983;12:123-124), Figure 1, which provides a schema of the apparatus, shows an inner "dilator." This appears to be a very important part of the device. Usually in such devices, after introducing an introducer and then a flexible guide wire and removing the intro118/67
ducer, the dilator is introduced over the guide wire in order to dilate the soft tissues and the opening into the vein. It is then that the catheter is introduced over the dilator and the dilator is withdrawn. In the description and directions for use, however, there is no mention of the inner dilator. There is mention under
Annals of Emergency Medicine
13:1 January 1984
A study was undertaken to determine the preferences of a patient population presenting to the emergency department of a community teaching hospital. During the initial intake procedures, the clerk asked patients two questions: i) Would you rather be addressed by your first name or last name by the nurses caring for you? 2) Would you rather be addressed by your first name or last name by the physicians caring for you? Two hundred fifty patients answered these questions during an eight-day period. These 250 patients comprised 24.4% of all patients seen during that time period. Inclusion or lack of inclusion in the study was more or less random, being decided primarily by which intake processor happened to care for a given patient. Of the 250 patients, 200 (80%) preferred to be called by their first names, 46 I18.4%) had no preference, and 4 patients (1.6%1 preferred to be called by their last names. Of the 250 patients, all but one had the same preference regarding nurses and physicians. These data did not vary with age. Looking at patients aged 50 years or older, the respective numbers were 44 (81.5%), 9 (16.7%), and 1 (1.8%). This study seems to reinforce Heller's conclusions, and
the data are remarkably similar to those he collected. Expectations in this matter certainly do vary considerably. We were struck by the frequency with which patients volunteered comments such as "I like the intimacy of being called by my first name," or "[being called by my] last name is cold," although one patient echoed Natkins's sentiments, asking "Can we call doctors by their first names?" It appears that, at least in this population, most patients prefer to be addressed by their first names by the physicians and nurses caring for them.
Robert A Rosen, MD Berkshire Medical Center Pittsfield, Massachusetts 1. Natkins L: "Hi, Lucille, this is Dr Gold!" lAMA 1982;247: 2415. 2. Cunningham J: Use of first names. JAMA 1982;248:1708. 3. Conant E: Addressing patients by their first names. N Engi J Med 1983;308:226. 4. Heller M: Addressing patients by their first names. N Engl J Med 1983;308:1107.
Blue Jean Hands Syndrome To the Editor: A recent case of interest that baffled our emergency department staff for more than an hour before diagnosis was that of a 22-year-old woman who was previously healthy and who presented with a chief complaint of "blue hands." This was noted four hours prior to her visit. The patient had been sitting in a language classroom all day and denied immersing her hands in dyes or paint. She was a nonsmoker and denied taking any drugs. Examination revealed an anxious woman with a light bluish hue to the dorsum of both hands. The hands were warm to touch and nontender, with normal capillary refill. The remainder of the examination was within normal limits. During the course of her evaluation the patient was noted to be sitting on her hands. She was wearing blue jeans. On closer examination, and with the use of an alcohol pad, it was determined that the patient's blue hands were the result of sitting on her hands while wearing recently put-
chased blue jeans. We propose that this previously unreported condition which may present to an emergency department be coined "Blue Jean Hands Syndrome." [The contents of this letter are the opinions and assertions of the authors, and are not to be construed as official or as reflecting the views of the Department of the A r m y or the Department of Defense.]
Carson R Harris, CPT, M C Associate Director. Emergency Medicine Service Daniel Evans, PAS Cornelio Mariano, MC Silas B Hays A r m y C o m m u n i t y Hospital Fort Ord, California
[Editor's note: Another point to be considered is not sitting on your hands.]
A Multipurpose Resuscitation Catheter To the Editor: In the letter by Redmond describing a multipurpose resuscitation catheter (February 1983;12:123-124), Figure 1, which provides a schema of the apparatus, shows an inner "dilator." This appears to be a very important part of the device. Usually in such devices, after introducing an introducer and then a flexible guide wire and removing the intro118/67
ducer, the dilator is introduced over the guide wire in order to dilate the soft tissues and the opening into the vein. It is then that the catheter is introduced over the dilator and the dilator is withdrawn. In the description and directions for use, however, there is no mention of the inner dilator. There is mention under
Annals of Emergency Medicine
13:1 January 1984