Wednesday, September 9, 2015

Hospital Hacks from History

People are hard-wired to enjoy novel solutions to problems using whatever is available to them. We used to call them "work-arounds" and today the common term seems to be hacks. Decades ago there were fewer regulatory and oversight agencies breathing down your neck, so we probably got away with hacks that would not fly today. Here are some memorable hacks.

Old time hospital beds were simple devices that were controlled by three hand cranks. The left crank raised the head, center raised the whole bed, and the one on the right raised the foot. Frequently, the wooden handles on the crank would break rendering the bed inoperable. Here is an effective hack for a non-functional left sided hand crank on an old hospital bed.

I never thought electrical hospital beds would come to widespread use because of the danger involved with patients having lines attached to them like EKG wires. If you whippersnapperns have a power failure rendering your beds inoperative, I imagine this hack would still work. It is rather crude, but very effective which is the hallmark of a good hack.

Many medical procedures were done on the ward at the bedside. Here is a hack for a proctology table with the objective of elevating the pelvis and lowering the trunk to pull the abdominal viscera down. Position a chair at a right angle to the bed with the back of the chair facing the bed. Now lower the entire bed so that it is about even with the seat of the chair. The patient is positioned kneeling on the chair facing the bed. For comfort (?)  pad the top of the chair  back with a bath blanket. Finally have the patient bend over the top of the chair back so his head is resting on the bed. An old time surgeon always referred to this as the "flying buttress" position. Patients were not amused.

The nurse sets up the proctoscope, swabs, etc on an overbed table and stands on the opposite side of the bed from the surgeon to restrain comfort the patient during the procedure. I always thought these procedures resembled a sword swallowing act done by someone that got their basic anatomy confused. The patients did not like it and the arthritic ones had aches and pains all over as a result of being twisted up like a pretzel.

Always use a big metal bath basin if your patient is vomiting. Whoever called those little kidney basins "emesis pans" never threw up. Maybe they just trying to put a good spin on vomiting, but I bet they never had to clean up the mess when someone overshot their puny little emesis basin with projectile vomiting.

Having trouble with that black band sliding around on your nursing cap? This hack works every time. Run a thin bead of KY jelly along the back of the black band before applying it to your cap. It will hold it in place and guaranteed not to leave a stain.

Radiators make excellent blanket warmers. Just stack them up and use as needed. On cold wards, your patients will love this hack.

An enema can is the perfect way to keep your patients'  flowers hydrated.  That tubing lets you access hard to reach vases and control the flow. Just remember to reassure nervous patients as you approach them with the enema apparatus that your only mission is to fill the flower vase.

Traction frames can be hacked for hanging just about anything from enema cans to IV bottles.

Finally, I saved the best for last. It's called a code brown containment system and I bet you are surprised an Old fool like me knows that Whippersnappern vernacular. The goal here is to keep all the stool on one level. When it starts running over the mattress into the bedframe or on the siderails it is much more difficult to clean up. Keep it all on one level. Get a shower curtain and cover the entire bed, then roll up bath blankets and position them under the shower curtain in a circle around the area expelling the effluent to act as a dam. This should effectively contain the mess to one level. The shower curtain area out of the containment zone can be covered with a drawsheet or towels so the patient is not lying on the bare plastic.


  1. Big smile here! I SO agree with you on those little kidney-shaped emesis basins being totally useless!! I always grabbed for the wash basin or small trash can... especially for a GI bleeder!
    Love the shower curtain idea for a code brown... on one particular pt., I remember having to using the wall suction machine because is was so liquid.

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  3. Thanks for the post.I found it very useful.Keep posting such wonderful stuff...