Monday, June 21, 2010

Rough Start

Watching the charge nurse running down the hallway, pushing a crash cart in one hand and yelling into a phone held in the other is never a good thing. Minutes after I had punched in, I followed the commotion to a cramped exam room, where an elderly patient who presented with shortness of breath had suddenly gone into cardiac arrest.

Crammed into possibly the smallest room in the department, we had senior resident at the head of the bed intubating, a tech on one side doing compressions, a nurse pushing meds, another nurse documenting, the attending shouting orders, another tech standing by to relieve compressions, respiratory elbowing through to set up a vent, an intern attempting to start a central line, and another nurse prepping drips.

The patient, who not an hour earlier had walked into the ER, was lying on the stretcher with clear plastic tubes sticking out of her mouth, both arms, and groin. The attending suspected a PE and ordered thrombolytics, which meant by my turn for compressions, blood spilled out of the ET tube, and splattered over my arms and face shield while RT suctioned. Shocked twice with no success.

An hour later she was pronounced, and, covered in blood and drenched in sweat, I shuffled out of the room with the rest of the team, listening to the patient's daughter sob in the chaplain's arms down the hall.

Not the best way to start a shift.

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