Monday, August 21, 2006

out with a bang

So I have 2 more nights in the ED as a full time employee. I start in the neuro ICU next Monday. I never really thought about "counting down" until tonight. My friend K brought a Jimmy Buffett theme cake and most of the dept was able to come in a grab some. I was in green and had my ass handed to me. Second night in a row that we didn't get a chance to eat. I ended up with 2 GOMER's (Get Out Of My Emergency Room) who were both old, sick and smelly. These are what we call "total care" patients. They don't do a think unless I do it for them. That gets old. I also had a cardiac ICU patient and a hispanic male (no english) with rocky mountain spotted fever. Loooonnngg night.

As I was getting ready to go one of my buddies came up tp grab me. He was in the trauma room and there was a sick as shitter coming. He has never had a patient get their chest cracked. (google Thorocotomy) This was a girl who coded at an outside hospital, was brought back with emergency drugs and then flown to us. She coded on the flight crew and they were doing CPR when they arrived. She had a right sided injury so the regular thorocotomy wasn't going to work on her. We did a clamshell... which opens from left to right and the sternum is cut from right to left instead of up and down. It allows more visibility of the heart. We gave her all of our emergency blood and used the internal paddles.

The shitty part was that is was Dr Rock who was running this show. UGH. He was the one who crossclamped the aorta. It figures that as we went to go upstairs the clamp came off. What a dildo. He bugs the crap outta me. So she went to the or and is more than likely dead. The success of emergency department thorocotomy is less that one half of 1%. So I left an hour late and played the cops angry rap music the whole way home. It takes a while to unwind from these.

The upside to all of this.... I had a new nurse with me and she got to see it all. Her eyes were HUGE! I hope she enjoyed watching as much as I have loved doing these over the years. I'm going to miss that. I'll be back, I know that..... but this was one hell of a way to finish things up!


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