Tuesday, December 14, 2010

I'm Back!!

So sorry for my long absence - a variety of factors (mainly exhaustion) contributed to my lack of desire to write something when I got home every night.

To catch up let me tell you about my most disturbing patients of the last week.

Patient 1 is a 13 month old female. For a few days she had massive diarrhea. This apparently caused a urinary tract infection - which her parents did not notice. She was urinating pus. They still did not notice. Good work asshole parents. By the time this little kid was brought into emergency she was basically dead. An RT was called over to collect a venous gas sample and while he was waiting for this he had a very bad feeling and grabbed the pediatric bagger. What ensued was a full code. The child went into cardiac arrest and compressions were performed and she was intubated. The doctor thought that she was so shut down and septic that once they began to give her fluids the toxins in her blood just circulated fully and caused major havoc in her body. She was airlifted a larger center - and I have no idea what happened to her. Some people should not have kids.

Patient 2 is a 35 year old alcoholic. She came in via a rural EMS unit and was direct admitted into our ICU. This patient was suffering from esophageal varices which was basically resulting in her bleeding out. It was the worst blood gas result I have ever seen. pH of 6.8, Bicarb of 5 and Lactate of 17. I am sure she will die. We were so sure that she would code that my preceptor and myself strategically placed waterproof gowns, faceshields and N95 masks near the room so we could protect ourselves quickly when the situation arose. I have never seen so much blood pouring from someone.

She didn't die on our shift anyway.

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