Tuesday, December 23, 2008

I'll Be Home for Christmas

Every so often, it's nice to score one for the home team.  A couple weeks ago I was working trauma when I saw a nurse grab a defibrillator and run to a patient's bedside.  I followed and found a middle-aged male with PEA on the monitor who had come in for an unrelated complaint but suddenly went into arrest.  I immediately relived the nurse doing compressions and brought him up to a rate of 112 (humming "Stayin' Alive" of course), while she grabbed drugs from the crash cart.  We did a round of CPR and meds while the resident intubated the patient, then paused for a rhythm check, saw V-fib on the monitor and shocked him into rapid A-fib.  

It was one of those rare examples where everything went right.  Witnessed, in-hospital arrest followed by rapid defibrillation.  Everyone from the attending down to me worked seamlessly together, doing exactly what needed to be done without wasted effort.  It was one of the smoothest-run codes I've ever been in, and I learned just before I left for break that the patient had left the hospital and was doing well.  

For another perspective on codes from someone concerned with more than just adequate compressions, go check out Shadowfax's recent post and his link to Happy Hospitalist.


Recovering Grady Addict said...

Witnessed arrests with immediate intervention (such as this one, in the hospital) are the ones who DO walk away.

82 year olds with HTN, CHF, Renal Failure, Diabetes, CAD, Muptiple Caths and Stints, eventually a CABG, -- alone at home.... DON'T. Sad reality. EMS just don't see the "saves" you guys do in the hospital. (sigh)

keepbreathing said...

Awesome. I love it when stuff goes right.