Friday, January 7, 2011

Wild Shift

The last month and a half have been surprisingly slow. Acuity had been down. I had been complaining the last two weeks about my lack of intubations, central lines, codes, etc.

Last night things finally blew up the way I was hoping for.

A 54 year old with a big head bleed that required IV anti-hypertensives and eventual intubation....

Then a healthy 42 year old male with chest pain. Good chest pain story for angina. He had murmur though, so I scanned him for an unlikely aortic dissection. Sure enough he had one, so it was time for an Esmolol drip and a cardiothoracic surgeon...

Then a good old case of respiratory failure that required intubation and a central line.

Then a seizing febrile 9-year-old little boy. After a full workup including lumbar was apparent that the flu got the best of him.

As I was wrapping up the LP, the charge nurse grabbed me b/c a trauma CPR was 3 minutes out. A 29-year-old was shot in the chest with a 9mm by his wife. I did a thoracotomy (cracked open his chest to try and repair the hole in his heart and clamp his aorta), but he died. I was feeling great tho!

Then 35-year-old who kicked the shit out of a concrete wall. He fractured and dislocated his ankle, meaning I got to consciously sedate him and reduce the injury.

My last patient was not exciting. He was a homeless man who wanted me to trim all his toenails. Fastest discharge EVER!

-ER Doc


Anonymous said...

Did you trim his toenails/get a nurse to do it? Or just send him on his way?


SerenityNowHospital said...

Discharged him right away

ER doc

Crazed Nitwit said...

Well, you're not an adrenaline junkie by any chance, are you?

As a nurse in a LTC I get to trim nails much more than I'd like. Knew I shoulda gone to med school. LOL.

Anonymous said...

We are pretty sick about this stuff are we not? I mean, the patient's and family’s worst day can be our best. I was a paramedic for over 20 years and reading your latest post brought back memories of intubating a patient in a car through the removed back window, lying on my stomach on what was left of the trunk. Doing chest decompressions in a field as an EMS helicopter landed along side of me, an external jugular IV as a huge crowed looked on in a very public place, and the last couple of years RSI's. That's about as "cool" as it gets for us but it was a huge rush and great diversion from the typical drunk with nothing wrong with him wanting to go to the hospital to try to avoid jail. Never had anyone ask me to trim their toe nails. Somehow, though, I now look at these stories with as much "how terrible for that patient and their family" as "how kewl for ER Doc (or for me)."