Friday, July 20, 2007

Another Day in Vegas

Here we go. Another workday in mid-swing. I have to leave for the track in a few minutes, but I wanted to take a few minutes and jot what's going on in my head at the moment. That is consisting of the activity of the last day and a half or so.

Yesterday sucked. We did either 7 or 8 calls in 10 hours - I lost track after about noon-time. One of our patients was a diabetic sign-off whose glucometer desperately needed to be calibrated. He lives at one of the mental health group homes, has a history of Type I diabetes as well as a number of Psychiatric issues. Well, when we arrived, the staff at the home told us that they found him eating raw meat and coffee grounds - he told them he was eating cereal..... They also told us that he blood glucose was reading "high" (which is where Fire Alarm got the idea that he was hyperglycemic, I suspect), but his mental status was suspect as was his skin color and moisture levels - he was pale and diaphoretic, not flushed and dry.... So we checked his sugar with our glucometer and guess what? It was at 38!! Needless to say, he got a line and an amp of D50. He woke right up after that....

Dealt with a burn victim - person who was deep-frying food and the oil flashed up and got her in the arm and the face. Fortunately only first-degree burns on the face and second-degree burns on the arms. The kitchen, however, didn't fare as well - it will need to be rebuilt. Fire Department did a lot of work to keep it contained.

We also had an unresponsive person yesterday afternoon - a frequent flyer that has COPD and often needs to be supported by intubation. That call was no different, but I couldn't intubate him because he had a gag reflex and we don't have RSI capabilities. So we bagged him with a nasal airway in place and got him to the hospital where he was indeed intubated. It was actually funny when we arrived; we got him through the resuscitation room doors, and I started my report with, "I believe you all know ...." That was met with a collective groan from the staff. The doc in charge of the case told me later that yet again he was given grief by pulmonology. I felt bad, but it wasn't my doing; the guy wasn't breathing effectively on his own, so we did what we had to do.

This morning I went to a 12-lead review class. It was quite good - more to follow on Monday when I do the second half with our educator. I do what I can as often as possible to keep my skills up, and this is one area where I feel I am good but I also need to keep up on it. It's easy to miss things if you're not careful.

Have a nice weekend - hopefully I'll write over the next couple of days, but who knows?

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