Monday, March 05, 2007

About Time

Finally... a decent night in the ICU! I was late so I didn't get to pick my patients. I didn't end up with a bad pair (fortunately).

The had two actual emergencies in the ICU last night. One of the male nurses (not Lurch, although he was there) had a patient who had a new trach due to a tooth abscess gone awry. Because of the infection his trachea had been pushed to the side and the trach (while scheduled) was a necessity. The weird anatomy was causing this guy to bleed from around his trach and into his lungs. He was awake and kept coughing pretty hard. Blood in the lungs does what any blood will do.... clot. W couldn't bag this guy and he couldn't clear his own airway. We tried to suction with no luck.

I ended up over there when the nurse started to panic. I bagged the patient as much as I could, calmed him down and told him to take a big deep breath as I begged him and then cough. He coughed, but something caught in the trach hole. I went to pull it out and pushed (like the Heimlich) on his stomach. He coughed out a clot the size of a gummy bear into my hand. Then he took a huge deep breath and started to relax. The surgery doc was at the bedside and was very relieved that the problem was solved. The patient did well the rest of the night.

After that I decided I was going to sit down and eat. Just as I was sitting I head one of the nurses yell for help. Her patient, a 97 year old man, was not responsive. Again, this was right up my alley. I ran over and his heart rate was 30.... thats bad. The "more senior" nurses were running around looking for.... who the fuck knows. I opened his airway and called for drugs. The poor patient went into cardiac arrest and I ran the code and helped with the geezer squeezer and CPR. The patient's nurse cried the whole time. Who the hell cries during a code??

Afterwards, I went to change (I got puked on) and ate my cold dinner. The charge nurse and other more experienced nurses came up and told me they were glad I was there.

I'm off for a couple of days. I am headed out to high schools Tuesday and Wednesday to talk to kids about drinking and driving. The cop's birthday is Friday.... still working on the evil plans for that!


Blogger Paradise Driver said...

Quite often, it is not what you know but what you "know to do", that saves the day.

In an emergency, there is no time to think, only to react.

Thinking causes emotions and indecision and there is time enough for that when you do the inevitable "second guessing" after the emergency is over.

1:30 PM  
Anonymous Anonymous said...

crying while coding..isn't that a punishable offense?

8:38 PM  

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