Saturday, October 20, 2007

A Short Break From Studying

I've been at it all morning, and I need a short break. During my stay here I've managed to contract a mild sinus infection. Unfortunately, it's viral (I got cultured last night right after my ED shift, no bacteria to be found) so I'm stuck with Ibuprofen, Sudafed, and Hall's mentho-lyptus cough drops to get me through it. But being the good student that I am, I've been since about 10:30 (it's 1:15 now) working away at cementing the material into my brain. The cement, unfortunately, is taking a long time to set.

Last night's shift in the ED was not as interesting as I expected that it would be. One of the only things that made it bearable was that Rob, one of the Paramedics in my class, was also in the ED. Today he's flying, and I hope he's having a good time. I'll have to catch up with him later and find out. Rob is from Shreveport, LA, and is a member of the Shreveport Fire Department. He also works for Caddo EMS, which is the area provider for Caddo Parish in the northwest part of Louisiana near the Arkansas state line. He's a young guy (at least compared to me :-) but he's an intelligent person and a good Paramedic. We got to work together last night on a couple of patients that were in the ED, one a 50 year-old male with a seizure history who was found down and profoundly hypothermic (I don't know what from). He was placed in a bear-hugger and had heat lamps on him, was also quite hypotensive and not breathing as effectively as he could have. During his stay in the ED, he got a total of 5 liters of Normal Saline, had an arterial line placed for monitoring his blood pressure in real time, and had a central line placed for access. Labs were drawn, and the cultures found that he was in urosepsis. However, as his core temperature rose (he came in at 32.5 degrees C, between 89 and 91 degrees F) and his pressure came up, he also woke up and became somewhat combative. He was fighting while they were trying to take X-rays and in CT, so he ended up being sedated. I'm not sure he was happy about that. At about 9:30 he was brought to the medical ICU and got the last bed.

The second patient we got to work on was a 44 year-old male who apparently is a frequent flier. He came in with mid-sternal chest pain, no radiation, and difficulty breathing. He has a history of hypertension, and is non-compliant with his medications. His pressure when he came in was 172/118. A 12-lead ECG showed a sinus rhythm with Q waves in leads II and aVF but no ST segment elevation. He also had QRS height in V5 and V6, possibly indicative of right ventricular hypertrophy, but clinically not indicative as it wasn't present in V1 or V2. On top of that, the nurses that were taking care of him told us that he has a habit of playing with the chest leads and making the electrical output jump around. I thought that was rather interesting.....

Anyway, back to the books as tonight I'm going to the Shock-Trauma unit. It is right next door to the Surgical ICU, and I'll probably float again just like I did last week. More on that tomorrow.

Powered by ScribeFire.

No comments: