# What do a chess set, high voltage and kidneys have in common?



## mycrofft (Apr 29, 2009)

Very hot day, you have two calls back to back.
The first: a construction worker became the momentary route to ground for 6 kilovolt wires through his arm. His partner knocked the power off after a couple seconds, breathing returned spontaneously after less than a minute. A white patch with a tiny black punctum in the middle is on his palm; by his elbow, a black tattoo like curlycue with tiny white spots in it. Pt is in great pain and cannotn use the arm. You start an IV, transport, and drop him off at the local ER.
Next run: high school atheletes "play chess" with a new kid; they lay out a chess set, and if the new kid can squat and pick up each piece in the following manner he can join the team: squat, pick up first piece, squat , return it to the board, stand. Squat, get that piece, stand, squat/return it, then do the same for the next piece, through all the pieces of the chess set. After the second bishop the new kid collapses. You start an IV and he perks up some in the unit, and you drop him off at the same ER.

As you drop hm off you glance in and see your first pt; he is sedated, a urinary catheter is in pace and copious wine-red urine is in the bag.

You stop by the ER after a few hours and the football wannabe is still there, and he too has a urinary catheter in place and wine red urine in the bag.

What is happening?
HINTS: the worker lost his arm, and both wound up on dialysis for a period.
These are from two real cases.


----------



## Aidey (Apr 29, 2009)

Muscle breakdown leading to acute renal failure? (Wild guess here)


----------



## mycrofft (Apr 29, 2009)

*Right on the first try!!*

Myoglobinemia, due to tissue destruction and initially exacerbated by dehydration.


----------



## Sasha (Apr 29, 2009)

I don't get this chess game.. they pick up a peice, squat, and put it back down? What?


----------



## 8jimi8 (Apr 29, 2009)

*think kegels*


----------



## DrankTheKoolaid (Apr 29, 2009)

*re*

hrmmm rhabdomyolysis secondary to the rapid muscle breakdown?


----------



## exodus (Apr 29, 2009)

Sasha said:


> I don't get this chess game.. they pick up a peice, squat, and put it back down? What?



With his butt.


----------



## AJ Hidell (Apr 29, 2009)

Sasha said:


> I don't get this chess game..


Trust me, you're better off not.


----------



## Sasha (Apr 29, 2009)

EWW that's so nasty.


----------



## curt (Apr 29, 2009)

Was the current AC or DC? I'm guessing AC, since he didn't get thrown clear. Kind of wondering if it's not a rip somewhere along the line in the urinary tract caused my stretching or sheering action on the body's part, meaning blood mixed with urine. 

 I generally would've agreed with the muscle breakdown theories but decided I wanted to try and look for zebras since we've already found the horse.

Edit: Nevermind, that's inconsistent with Dialysis being a treatment.


----------



## mycrofft (Apr 29, 2009)

*No they don't clutch with their glutes*

It's a prison trick to kill someone. When you have picked up your third piece you have completed six full deep knee bends (first set of one; second set of two plus the first is three; third piece, those three plus the three for the third piece). 
Fourth: those six plus four is ten TOTAL.
Fifth: those ten plus five is fifteen.
Sixth: fifteen plus six is 21 total...28...36..and that is just the back row. A CHESS SET HAS FOUR ROWS, black and white. My finger and tow counting is an even six hundred full deep knee bends. You usually have a deadline and big nasty guys to enforce it. Drop one or fail to stand up straight and they restart you.


----------



## Aidey (Apr 30, 2009)

So whats the answer?


----------



## Sasha (Apr 30, 2009)

He already answered that :]



mycrofft said:


> Myoglobinemia, due to tissue destruction and initially exacerbated by dehydration.


----------



## Aidey (Apr 30, 2009)

oops! That is what I get for clicking the little "new posts" arrow rather than just scrolling down, lol. 

It was 1/2 luck and 1/2 education. I used to work in a dialysis clinic, you hear a lot about the different causes of kidney failure there.


----------



## AJ Hidell (Apr 30, 2009)

I saw half a dozen such cases during two tours in Iraq.  Guys with a lot of time on their hands, no place to go, and very little entertainment options, often decide it's a good time to hit the gym.  Unfortunately, you get a lot of he-man jarheads together, and instead of any intelligent system of physical training, it's always just a lot of full-on, maximum weight slamming to impress each other.  The older guys, and the guys who haven't worked out hard in years (or ever) are especially susceptible to this.  And you have not seen a man freaking out until you have seen a guy after he's peed a toilet full of frank blood.  It takes a competent practitioner with psychosocial skills to successfully reassure them that it is not bladder cancer or the Iraqi clap.


----------



## fortsmithman (Apr 30, 2009)

AJ Hidell said:


> it's always just a lot of full-on, maximum weight slamming to impress each other.


When I work out if there are no ladies present in the gym then I do a reasonable workout.  The moment a lady walks in then I and some of the other guys tend to lift more weight then we should.  Because when I'm working out I don't want to impress other guys it's the ladies I want to impress.  Because I want the ladies to notice me not guys.


----------



## Aidey (Apr 30, 2009)

He's talking about Marines and Army guys. Logic doesn't apply.


----------



## AJ Hidell (Apr 30, 2009)

fortsmithman said:


> ...when I'm working out I don't want to impress other guys it's the ladies I want to impress.  Because I want the ladies to notice me not guys.


You'd never make it as a Marine.  

Although, on Marine camps and bases, you will find the best selection of fine ladies in the military, and they love the gym.  If I had nothing but Army hags to look at for those two years, I would have gone AWOL.

EDIT:


Aidey said:


> He's talking about Marines and Army guys. Logic doesn't apply.


ROFL!  Exactly!


----------



## fortsmithman (Apr 30, 2009)

AJ Hidell said:


> You'd never make it as a Marine.


I don't want to be a marine.  I'd much rather be in the RCR.


----------



## mycrofft (Apr 30, 2009)

*I love this "place"!*

So now we're comparing the fairer sex in each branch of service? 
Fair enough!


----------



## AJ Hidell (May 1, 2009)

mycrofft said:


> So now we're comparing the fairer sex in each branch of service?
> Fair enough!


LOL!  Things have changed since I first enlisted in the 70s.  The Air Force had all the hott women then, followed distantly by the Navy.  The Marines hardly had any women at all, and the Army had the ugliest.

It's changed in the last decade.  Now the Marines have the hottest women, followed closely by the Air Force, with the Navy a close third place.  The Army is still the pound.  Why do you think I volunteered to deploy with the Marines?


----------



## mycrofft (May 1, 2009)

*AJ, someday you will learn...*

"All women are beautiful, some more so than others". (R.A.Heinlein).


----------



## marineman (May 1, 2009)

AF is making another comeback. Went to visit my uncle last summer, he teaches at the academy in springs and my word are there some lookers.


----------

