Vaca comes to an end

I return to the Emergency Department tonight for an 8 hour shift 11p-7a! I am excited to be back. Vacation was great but now I am ready to go back to work and looking forward to it.

Vacation

I started my Vacation yesterday! I am leaving for DC for the weekend with my Boyfriend in the next couple of hours I will return on Sunday and I am off till November 25th 2009.

Great start and awesome finish!

I get to work and head to the cafe to get some thing to eat and drink as soon as I get back into the ER “sitting charge nurse” comes up to me and says Mikey I need you in MB(major bay) 2 for a cath lab we are short a nurse ATM (at the moment). Patient is a male coming from the city. Heart alert was called by EMS so cath lab team was already in route ( you may be thinking to your self why are they not there it was because this is 11pm)  a group of 3 of us handled the cath lab patient and had every thing ready in less than 11 mins. While the patient was being run down the hall way by another tech.  I am called to MB 3 for a patient in SVT ( Supraventricular Tachycardia)with a heart rate of 190. PT does have a history of SVT. While the nurse is starting an IV lock I start doing the rest ( hooking up the EKG monitor, B/P, O2 and the AED for possible Cardioversion) on the EKG patient was still in SVT at now a  r ate of 196. We push 6mg of Adenosine (one of my fav. drugs) it was pushed and the arm goes up in the air ( makes me think of a flag going up). with in 5 secs the patients is coached into taking slow deep breaths as his/ hers  heart rate starts to break (slow down). After the 6mg of Adenosine is giving and the couple of seconds goes by her heart rate is now 110 and showing sinus tach. on the EKG. 20 mins goes by and she is she is in normal sinus at a rate of 84….

In the last 40 mins of the shift we get a/an EMS patient from a pretty good distance from the ER. Patient is a diabetic found unresponsive with a blood sugar of 14… EMS is not able to get an IV. They give Glucagon IM and it brings her sugar to 46. She gets to the ER and we are not able to get an IV site (protecting left arm) and we need one  yesterday on this patient with her sugar being low and her temp of 95.2… ( warn blankets and bear hugger applied. With no IV site we can not help the patient the best way. So the doctor comes in and does a EJ and we are able to get the patient some D50( a medicine to higher the sugar)

While that patient is getting D50 we get a RD and a Chest Pain Patient. Getting 3 Critical patients in in the last hour of the shift at the same time and having 4 people do every thing that is needed for the patient in that short period of time is amazing.

What a great shift

the fight to stay alive

One  thing I have learned over the years is never try and guess what a patient may want when it comes to any thing that could save their life as in being put on a breathing machine or any thing of that matter.  Like last night EMS comes in bringing a 92 YOM (year old male) with O2 stat of 85(normal 90-100 depending on patients past medical history) just by looking at the guy you would never thought he was in his 90’s but you could tell that he was really fighting to breath.  The doctor goes to a family member and he says those words that just send chills down my back every time. ” Hello my name is Dr. ******** I have a question for you as the family member as well as for the patient.  Your father looks to be having some trouble breathing and is really fighting to keep his O2 stat up. If for some reason he is not able to maintain his oxygen level how would you and the patient feel if we put him on a breathing machine and help him breath”. The family member saying ” I dont think he would want it” and then the patient saying taking in short fast breaths “I have been on it before” ……… We intubated him and his O2 stat got better and then moved him up stairs. It still shocked me just  how much you are able to stiff fight to stay alive but to me after seeing his family and who was there  for him he had the love and passion to stay alive as that is some thing I have always believed  that people (some) will fight as much as t hey can no matter what to stay alive.

Love is a strong word with that has meaning I think some people dont understand. Love is a four letter word that can kill a person and one that can save a life.