Betting On Abdominal Fluid

Bed 12. Eric hasn't assisted in a paracentesis before, so he called me to "teach" him. I told him to gather the following materials: thoracentesis/paracentesis tray, sterile gauze, betadine, sterile gloves, and evacuation bottles (vacuum bottles). I wasn't sure how much fluid we'd be draining this time- I didn't know how many bottles we needed for the procedure (a bottle can contain about a liter of drainage)...so I entered the patient's room.

"kumusta po kayo? (how are you doing?) Can I take a quick peek at your abdomen?"

Our patient, a skinny Filipino gentleman in his 50's, was kind enough to let a lowly emergency room tech observe and palpate his very painful and obviously distended abdomen.

"Okay Eric, maybe 4 bottles."

After setting up everything, we called in Dr. Ho to perform the procedure. After the entire shebang of abdominal poking, we were ready to drain. First bottle down. Then another. Then a third.

This time on the third bottle, the drainage rate got slow and a little bit predictable.

"Hey Reinier, do you have a dollar?" asked Keith, the RN for bed 12. "Eric?"

"Uhuh. Why?"

"I'm betting this will stop at 2.3L total."

Eric bet 2.4.

Me? Well it was a great opportunity to get two bucks. Understanding the great implication of getting $2 tonight, I had to gather my intelligence, experience, power, magic, lust, gut-feel, and hunger. I needed to make a crucial decision- getting two dollars meant a burrito from the vending machine downstairs or maybe a twinkie plus two quarters for gum. The extra bucks will have a profound economic impact on me, as well as a physiological (digestive) one...I was hungry, and I had no money on me!

"Hmm...considering the rate of flow and the consistency of the fluid, I'll go with 2.250." I had to be more accurate. I used Poiseuille's Law and Viscous Fluid Mechanics. The flow rate was reduced. It seemed reasonable that it would not fill at least half the bottle. Plus the urine-looking fluid turned red and more viscous. Drainage would be halted anytime soon-the diameter of the tube would not be able to accomodate the dense, almost pus-like fluid. I can't go wrong with this.

A few seconds later, it was clear...I AM GETTING F*CKING TWO DOLLARS! WOOOOOT!!!

Although I got my prize, I saved the two dollars. Didn't go downstairs to get that heavenly burrito or that magnificent twinkie. I just decided to appease my hunger by eating the free oreos from the social worker, the stolen bagel with cream cheese from the operating room, and ingesting copious amounts of free coffee and soda from our breakroom.

It was a great situation to be in. Getting money and free food. Thank you, physics and physiology lectures!