Thursday, December 20, 2007

Where Have All The Good Men Gone?

So; in addition to screwing the pooch by arriving 3 hours late for work (and having to confess to a five hour oversleep), I returned to my role as Angel of Doom.

As part of my ongoing quest to establish my rep as the Resus Hog, I spent my entire night therein. Yesterday was particularly Code Blue-full. And we seemed to have a special on Paeds, too. Buy one, get one free - that sort of thing.

Some days, one can't move for Docs milling around resus; somedays - no-one. At one stage yesterday, I had ownership of all tree resus bodies. Now, admittedly, they were patients who could tolerate being left alone for 5 minutes at a time. So I could attend to one, start treatment, go to the next, assess and treat, and so on. With good nurses, a body can just about manage. As I'm sure you can imagine, it doesn't take much to bring the pack of cards down.

So, of the 3, one was an exacerbation COPD. Blood gas, CXR, quick eyeball. Hypoxic, but not hypercapnic; chest mostly clear. Up on the Ox, bounce to magicians. Next, small(-ish) pneumothorax; little local, quick aspirate, repeat the CXR. Third was , sadly, the worst. Young fella, flat GCS. History of brain mets. Another quick lookover, open the airway, crank the Ox.

I am holding it together... until - Paediatric Code Blue, Now...



COPD is holding her own, better on the Ox, started on antibiotics. Good, she can escape resus, and onto the medics. Pneumo boy is a little better, but not all the way. He too, can leave, but not all the way... I need to see him in a bit. GCS 3 clearly isn't going anywhere, but I can't manage him and an emergent kid.

The call goes out for another Doc.

In comes the kiddie. Shortof breath, now hot, altered, foaming at the mouth.


Another pair of hands?

GCS 3 is stable - as he can be. Fine; to the kiddie then. Still hot, but not foaming now. Another doc, please?

Anyone? Anyone? Anyone?

Just as we're finding the right sized mask, and after a third call, help finally arrives.

I guess the down side to being the Resus Hog, is people jus leave you to it? I reap what I have sown...

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