Patient comes in with acute asthma exacerbation. They say they've taken their puffer a million times and isn't helping. I ask them to show me how they use it. And then do something like this: It seriously happens a couple times each week. Normally it's something less egregious, like exhaling when they should be inhaling or firing the meds into the back of their mouth and not sucking them down into their lungs.
I've spent way too much time in emergency rooms. Once, while at a friends house, I left a car I'd just purchased the day before at the top of his driveway( a hill). It was idling as we'd only expected to be a minute. While standing at the bottom of the driveway with my foot on the trailer hitch for his boat, the emergency break on my car failed, it rolled down the hill, and proceeded to crush my foot between the trailer hitch and my cars bumper. At the ER, my toenail was removed so the doctor could stitch up the cut underneath it. Even with a ton of local anasthetic, having my nail bed messed with was one of the more painful things I've ever gone through. Months later, after the nail had grown back, but still not really attached itself that well due to the scar tissue underneath, I had to get my wisdom teeth removed. I was recovering at my mothers house that afternoon, after who knows what kinda pain killers, and a UPS guy swings by to deliver her new computer. He slides it in, and over my foot, which promptly removes my toenail again. He goes crazy that my nail is now standing up vertically from my toe while I'm so out of it on pain killers that I just look down, giggle and tell him it its no big deal, but thanks for the computer. My sister then went crazy when I chose to remove the toenail with a pair of pliers. It's since grown back, again, but still looks weird thanks to the scar under it. I've also had to go due to a motorcycle wreck where I tore up my knees and elbows pretty good. One of my knees was bad enough that they decided to check it to ensure the joint was still intact and hadn't gotten anything in it. This entailed putting a syringe into it and pumping fluid in until my knee was the size of a grape fruit. Afterwords, once they decided it was fine, the doctor was nice enough to cut all the extra little bits of skin hanging loosely around the wound off and set them on a piece of paper on my chest. Even with the local anasthetics, it was still just surreal watching someone cut pieces of your own skin off and set them on you. I also got to spend Christmas of 2008 in the ER thanks to a random seizure while I was in the car with my girlfriend. First one ever, and I was 30 at the time. The doctor decided it was the result of withdrawel from drugs and kept accusing me of using something, then interrogated my entire family as to what sort of drugs I used. For the record, I was not on anything and have never actually even tried anything to begin with. After an Xray, EEG, MRI, catscan, and lots of bloodwork, the results were that I was slightly dehydrated, and my electrolytes were low. I may or may not have yelled that it was fucking retarded to think a bottle of fucking gatorade was all that I needed to not have a seizure.