Wednesday, June 9, 2010

Cavi Wipes: My new best friend.


What a day! In no particular order:
  • Decannulation: An elderly lady who had her trach plugged for three days! We were finally pulling the trach out! It was kind of anti climactic since the trach had recently been downsized, and there was no cuff. I undid the ties, and it it just kind of fell out. I am not entirely sure she even knew what was going on, even though we explained multiple times. 
  • ECG's: This is no longer new or special. The only kind of interesting thing about it today was that I got to do one on an 11 year old boy. 
  • Bedside Spirometry: Now, I think this guy was pretty lonely, because from what I have heard, young children grasp the concept better than he did. We got zero good tests, and his FVC actually DECREASED after we gave the bronchodilator.
  • The usual bedside O2 therapy, bronchodilator therapy, and trach care. The RT's actually just give me a list of patients, and a pager and tell me to meet them later. I usually respond to the calls for ECG's (because I like them so much - except the ones in psych).
  • And last but not least by any stretch of the imagination...
A patient presented in the ER with stomach pain, due to over use of NSAIDs from a shoulder injury. Docs were doing a routine scope when they dislodged a clot in a bleeding ulcer. Massage GI bleed ensued. We were called to do a stat intuabation. Intubation complete, patient receives 3 units of blood, and turns from a ghastly white to a humanish color. I am bagging, but since he is not completely sedated he is fighting the tube and the bagger is making that awful honking noise. The Docs attempt another scope to try to stop the bleeding. This involves copious amounts of saline and epinephrine down the scope. Patient retches and vomits wave after wave of blood. Everywhere.Eventually the bleeding seems to stop. Thankfully we inline suction, after he has been stabilized and transfered to the ICU, and get no blood back. The cuff worked! Patient is placed on ventilation, and less than one hour later is extubated. 

And this is why cavi wipes are my new best friend.

In other non-hospital related news I have modified my shower curtain. Yes, this is how exciting my life is when I am not at the hospital. It is a corner shower unit, but for some reason it does not have a glass door, but instead someone MacGyvered a shower rod and curtain to cover the opening. The shower curtain was about 6 inches too long and just sat bunched up in the bottom of the shower. Lord knows how many people have moved in and out of that place with the curtain like that! I couldn't deal with it at all. The bunched up shower curtain took up valuable showering space. I took the curtain out, and cut off the 6 inches at the bottom (which looked like it was growing its own little eco system of grossness). Now things seem much nicer in the shower and no one else has even said anything. I also went crazy on the stove, which looked like it had about 15 years of college student food burned onto it. My room mates just hide in their respective rooms all of the time - except when they are burning food onto the stove apparently. 

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