Thursday, May 2, 2013

Worst smells

The worst smell in the hospital (and definitely at home) in my opinion is vomit. Of all smells, I find that the absolute most detestable. I think I'd rather be in a room of C diff diarrhea than a room of vomit. (Sadly, there have been situations where I've essentially been given that choice.)

What do you think? What is the worst smell in the hospital?

(P.S. Isn't this the best topic EVER??)

41 comments:

  1. Homeless person's feet.
    Do NOT take off their shoes!

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  2. Melaena wins. Every single time.

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  3. Really, *really* bad cellulitis. Took one patient to A&E with it (after leaving a concerning amount of their leg skin adhered to their armchair). 20 minutes stuck in a truck with that smell *gag*!

    Of cause, the ambulance officer at A&E parked us in front of the nurses station while queuing, which made us oh so popular...

    That was the evening I learnt of the wonderful thing that is eucalyptus oil.

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  4. Rectal gangrene is also fun...

    shudder

    Memory from 3rd year surgery rotation.

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  5. Count a second vote for gangrene

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  6. abdominal surgical wound infected with anaerobes...could smell it on the entire floor...

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  7. Pus. Had a patient in the ED with an ENORMOUS perirectal abcess that had tracked down into his thigh. When the resident on call lanced it, I swear what must have been two quarts of the foulest stuff I've ever encountered splattered all over the floor. The smell was almost visible as it made it's way down the hall. Everybody in the ED stampeded into the trauma bay and we sealed the doors with tape and towels. The smell was still there when I came back on shift two days later. That was 22 years ago, and I still remember that smell like it was yesterday.

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  8. Sadly the worst smell I've ever encountered was in my car, not in the hospital... My puppy ate cat shit, then got car-sick and vomited cat shit IN MY CAR. Worst smell I've ever smelled.

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  9. Perirectal abscess. The odor of that pus will peel paint of the wall.

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  10. Took care of a lady one time who was on hospice for a fungating breast tumor. I remember changing the dressing, and having to run for the bathroom to vomit (and I have a strong stomach after years of ICU and OR). I never went in that room again without vicks dabbed in my nurse, and still!

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  11. Not that it's necessarily the worst, but there are some chemos that REEK. I can't remember which ones.
    -Dr. Alice

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  12. A gangrenous foot that hadn't been taken out of its shoe in four days. The moment I walked into the ER and caught a whiff of it, I thought "I really hope that isn't my patient". When the smell got stronger as I walked towards the patient's room, I knew that the universe was against me. I can still vividly remember the smell two years later.

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  13. Veterinarian speaking here...deobstipation of a constipated cat wins hands down.

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  14. At home, yes, vomit is the worst. In the hospital, well, read upthread. I was definitely going to say gangrenous foot but I think perirectal abscess may win.

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  15. Pseudomonal perirectal abscess. Makes everything else seem like Chanel No. 5.

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  16. had a patient during my intern year with fungating scc - actually started in the scrotal/perineal region, spread to anus, as well as skin of buttock and thigh. we were using dakins dressings on it, which made the smell even worse. shudder...

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  17. For me it's a toss-up between parvo (I'm a vet tech, so think horrible melena and nasty vomit and combine the two in a very sad, sick puppy) and the DMSO breath of some of our oncology trial patients. For some reason that particular chemical is excreted so strongly in their breath, and I basically have to sit in a small enclosed kennel with them for an hour doing vitals and bloodwork every 10 minutes...it's awful.

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  18. nasty, pus-filled, festering wound

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  19. Sacral decubitus ulcer 10x14 cm with involvement of the rectum, multiple abscesses, pseudomonas, fecal contamination. Dakin's solution is a greater invention than penicillin for some circumstances.

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  20. a person who was unconscious for 2 days before being found and taken to the OR... all the smells mixed with the urine... unbearable.

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  21. Holy Abscess! Mind you it is not smell more of a visual thing. WARNING this is not for the weak. Check this guy out http://www.youtube.com/watch?feature=player_embedded&v=fOsoFwpJtWc

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  22. My top three from the veterinary world are (in this order):

    1. Infected ear tumor in a dog
    2. Infected anal glands
    3. Stress colitis diarrhea

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  23. Ugh. I'd have to agree and say the worst I ever smelled was a nasty huge perirectal abscess drained in the ER, on my first travel assignment. The surgical residents decided not to go to the OR, but they wanted to "keep the ER door open to air it out in the room."

    It was the absolute worst. We shut down a whole station because of that.

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  24. pilonidal....i echo the above.

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  25. Perirectal abscess and GI bleed (runner-up:vomit)

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  26. Nasty 6 month festering bartholins abscess...

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  27. Anaerobic infection of a traumatic amputation. I was instructed by the attending orthopod to debride until I vomited, then as soon as my stomach calmed to go debride some more, repeat until I found healthy tissue or the other side of the patient...

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  28. My feet... After being in the hospital for 24 hours

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  29. Perirectal abscesses being drained are definitely rank, but the worst I've ever had is a lady who was 12 weeks post surgery for peritoneal cancer. Her abdomen had been increasing in size since the operation and the abdominal wound site just decided to burst open... 12 weeks after the surgery. Necrotic fat mixed with pus and who knows what else just poured out of her like a running tap when we took the dressing off and tried to sit her up for a sample. Stunk up half the ED... Won't EVER be able to forget that stench...

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  30. Autopsy on a patient that had recto-vaginal fistulas. She'd been on palliative care for a week before she died, the stench of feces incubating in the warmth of the vaginal vault and the subsequent infection of genitals/rectum/and skin is indescribable.

    I am not phased by gangrene, feces, stomach contents, decomposition (bloated, green, insect breeding decomposition), exhumed bodies, etc. But that... that was a memory that haunts me.

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  31. Oh hell yes, vomit is the absolute least of your worries. See above, all of which I've encountered, but not in the quantities described! (yet)

    I'll just make one up. How about gigantic septic pustulent purulent partially necrotic rotten gangrenous weeks-old intestinal abscess with melena contaminated ascites? (I ran out of adjectives)

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  32. pilonidal cyst was the worst I remember, but some of these descriptions would probably be worse! Glad I am in outpatient general peds and not surgery or nursing with old people!

    (gotta love that one of the "captcha" words was lochia!!) :)

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  33. from the patient side, i dont really mind the smells of abscesses that much, though one of the worst was a pseudomonal fournier's gangrene.....gi bleeds and c diff aren't nauseating, though enable a diagnosis the second you (or the afflicted patient) enters the department

    from the drug side of things, acetylcysteine (essentially just glutathione); and along that same line, if you ever have a chance to smell amino acids in pure liquid or powder form (TPN compounding) youll understand what bad smells are

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  34. The GI ward on morning rounds when the breakfast man is delivering toast. The mix of lovely warm fresh toast and ischaemic stoma, melaena and purulent abscess. Ruined toast for me.

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  35. Cervical CA, but a diabetic foot comes close

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  36. Pilonidal cyst is up there, but the worst one was in the cafeteria... and before you laugh at the "joke", it's because their chicken soup smelled exactly like the oozing bed sore I'd just been dealing with.

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