Monday, June 21, 2010

Well no one died today.

Everything was pretty routine today  -

I did an ECG (I clearly do a lot of ECGs. This is mostly because everyone hates them and as soon as they can train a student to do it the happier they are) on an elderly man who did not speak english. He was in a lot of pain, of undetermined cause, so he had both of his arms crossed over his chest and would not move them. This took a long time. I put the stickers on the wires, and stuck them to him blindly under his arms. The only thing worse was the lady with a shattered left shoulder that was taped to her. Sometimes people do not like me. 

I was walking up to a floor, when I heard a clatter and a nurse shouting, "Don't you hit me!" Repeatedly. A man wielding an IV pole, with a chest tube in situ was hitting a nurse in the hallway. He then ran into the stairwell and slammed the door on his chest tube.... which he then PULLED OUT and fled down the stairs. Security tackled him. I was hiding behind a door, peeking out the window. Shortly after I entered a patient room, and awoke her. She looked at me as confused as could be and said, "I heard they found a body." Um you were dreaming! Code white does not mean we found a body in the stairwell. 

 - and then CODE. A woman was at the casino and went down hard in the bathroom. The security guard followed her into the bathroom (I guess because she looked unwell?) and witnessed her go down. CPR was started almost immediately. This particular lady has terribly fragile skin, which was torn by EMS on BOTH arms.  I opted to not try for that ABG - her arms were just bleeding everywhere. I got yelled at by a nurse because I didn't have any saline in my pockets to assist with dressing her arms. Right - the saline in my pocket. I'll remember that for tomorrow. In the midst of the melee, lab was drawing blood cultures, and having trouble getting a vein. This smart ass RN (and I do love nurses dearly) cuts open the dressing on her arm and starts palpating the radial artery. My superior asked him in no uncertain terms what the hell he thought he was doing. The RN was totally offended, and thought he should be able to just draw off the artery if he felt like it. This happened not 5 minutes after my superior did a femoral poke, asked JACKASS RN to hold pressure on it, and the RN turned around and just taped some gauze on it and walked away. Art pokes are serious business! It's not that this jackass RN couldn't do it, it's more that he's not certified to do it. What if something went wrong. 
Anyway. I got more blood on my shoes. The patient was responsive to pain, but would not open her eyes. 
The thing that always gets me is not the patient so much (except for that one pediatric code) but more the family of the patient. This lady had a very sweet husband who was just crying at the bedside. He kept talking to her and saying things like, "Oh sweetie, open your eyes. No sleeping before supper!" It's so sad. I have already learned to completely detach myself and become all business around patients in emergent situations - but I can't do it with their family. 
I left as they were transferring her to ICU - I guess I'll find out more tomorrow. 

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