Sunday, July 06, 2008


Wimbledon is going to the wire as I write...

So - yes, a fractured clavicle, which was spotted; but as the second recall X-Ray shows, a few busted ribs too. Try as I might, I cannot see them on the original, even with the advantage of digital viewing, denied you guys...

It's still not a brilliant image, but I think you can see the healing right sided rib injuries. Thankfully, no underlying lung damage.

Nights pass, as they do; Friday was busy for TooTall Student, so I think she got a good flavour of the ED. My main flail was trying not to call her by La Belle Fille's name... We ended on a Shroom 8 a.m. special. Just as we wound down for handover, the call came in, courtesy of BatPhone. The real deal - 40s, cardiac arrest 15 minutes away. !5 anxious minutes to try and gear up, try and get your mind running again. The nurses change at half seven, so they're fresh, but we medics all smell a little fusty. It's an odd scenario, as the bustle in resus goes on with the night guys drifting out, saying their goodbyes, making breakfast plans...

As our patient arrives, so do the day staff; we're short handed at weekends, so I stay and DayReg takes handover; he floats on the periphery, filling in the little details that my morning brain can't quite fix on.

The damage - a young fella, we think he has Wolff-Parkinson-White, an electrical short-circuiting of the heart, predisposing him to arrhythmia; we think he may have taken some drugs... we know he was found down at 7, we know he had no output at quarter past. He is unceremoniously dumped on our trolley, the Ambos herding round, bright-eyed, a sheen of sweat on a few brows; they've done their bit, and done it well. They know this, and don't need me to tell 'em, but want to know if we can finish what they started.

Chaos ensues, for a minute or two, checking the tube, forcing air into unwilling lungs, hands slipping on his greying chest. Then, we pause, come up for air, re-assess.

Got him.

Weak, yes; thready, yes. Hardly a thing to be proud of, but he's got a pulse. His rhythm is crazy on the monitor, never staying in one place long enough to get a fix. More drugs, more air. ITU and Cardio arrive.

Lost him. Four more frantic minutes until we find him again, pull him back over the edge. ECG shows a large MI, and we know why; the CathLab is being warmed up - we have indeed moved into the 20th Century - but I'm not sure we'll get him there.

Thankfully ITUMan is. He doesn't strike the epitome of cool across the room, but he is. Collected, organised, he casually takes over... and I am glad. Slowly, the patient heaves to, listing a little, for sure, but slowly doing what we want him too. ITUMan disabuses me of some ideas about the properties of fentanyl, and I feel generally clumsy next to him. I blame my 8 a.m. brain.

No matter; just under an hour later, he rolls out, with our patient, stable for now, onward to the CathLab. From what is undoubtedly at least two people's public tragedy, we are all smiling. We've done well, here today. Done what we were paid to do. We don't know if it will make any difference in the long run, but that's not our job. A little messy, disorganised? Probably; I expect I shouted a bit too much, too, but he came in dead, and went out alive... cliched?

Sure, but right now, I don't really care.

They're still on at Wimbledon...

1 comment:

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