Thursday, January 28, 2010

"...Had The Pope And I Not Been Out On The Razz..."

I left the previous post in situ, tho I'm not sure it says very much, except that I am grumpy; and not firing on all cylinders, not at m best.

Off game enough to recuse myself from work? I don't think so. I hope not.

In the aftermath of the Wakefield trial, I want to write something about trust, but it will have to wait.

I'm too tired.

Instead, a teaser from today.

One increasingly finds that the junior staff to whom I refer fail to grasp the point when I'm referring someone I think is really unwell. Unless, of course I use the phrase 'really unwell'. Which I don't like too, unless I really have too.

So, tonight, a poor unfortunate arrived in he ED quite literally spitting blood. He had had his tonsils removed a few days previously, and in considerable pain since... until this evening when the pain suddenly ceased. Unfortunately, this relief coincided with torrential bleeding, presumably from the wound. For those not in the know, the tonsils are anatomically very close to the carotid artery. Bleeding from the tonsillar bed can be catastrophic, not only in its volume, but because its location compromises the airway, and makes it difficult to apply Shroom's Blunt Haemostat. (That is, press on it)

As he rolled in, I was on the phone, pre-warning the ENT SHO of his arrival. When he rolled through the doors, he had two vomit bowl on his lap, brimming with congealing blood, and a steady flow of clots was joining them. I relayed this information to my colleague on the phone, and explained that i thought she and her registrar might want to come see this guy.

She asked a few vital questions (what was his full name, date of birth, that sort of thing), and then casually told me that she and her Reg were reviewing a patient on the ward, and would make their way down when they could.

I told her that was fine, but made her promise to tell her Reg what I'd told her before they went on their ward round, and let him make the decision about which patient was more important.

He was out of breath when they hit the door, two minutes later.

Next stop, theatres.


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