Friday, July 11, 2008

Friday Night

My son is performing in the Majestic Theater's production of "Big" tonight - it's the opening. I really wanted to go, but I didn't get much sleep last night and I ended up working most of the day today. Plus I did something with my neck that I still can't figure out. So I'm off to bed very soon - probably as soon as I finish posting this entry.

Yesterday was my first "real" shift in Boston. When I say "real", I mean that is was my first scheduled regular shift. And it started off in a somewhat negative way. Our first transport was a 76 year-old female with a really long medical history. She had a tracheal stoma, for one thing, plus she had a history of episodes of sudden cardiac death - she'd been brought back to life on 4 occasions, according to her chart. Anyway, she was on one of the critical care units going from West to East Campus for a colonoscopy to rule out a GI bleed. On top of everything else, she was pretty anxious about the procedure as in her case they were doing it under general anesthesia. Well, we got her loaded aboard the ambulance and I was starting to get my assessment done when she had a sudden onset of respiratory distress. Not a good way to start out my career at Cataldo, I don't think.... It turned out she had secretions in the stoma that had to be suctioned out (I forgot to mention that she had MRSA in her sputum), and I ended up having to bag her to get her breathing effort under control. I had to grab my partner for a second set of hands, so he stopped the ambulance right on Brookline Avenue, lit it up, and jumped in the back with me to help me get her under control. We brought her back to the ED, and the triage nurse gave us a hard time, or at least tried to. Jason, my partner, replied to her that this was acute and the ED was the right place to go. That was awesome....

We had another really sick person - an 80 year-old male with metastatic cancer of unknown origin who was hypotensive and was suspect for aspiration pneumonia. He was pretty sick with a blood pressure of 88 systolic and a heart rate in the low 100's. They'd gotten in an IJ (an EJ that's cut down and sutured in instead of placed with an IV catheter) so that they could monitor his CVP (range is 2-6 mmHg and his was 5 when we got there - he'd come in at 1) as well as two peripheral IV's, he was getting fluids (I think he was his 6th liter of saline or something like that) and they were considering pressor drugs. I know that there was also a question of bleeding somewhere as they had him typed and screened. They also sent staff with us to the ICU - I'd wished they'd sent respiratory with us when we took the woman across earlier, but it wasn't to be.

I actually got about 5 hours of uninterrupted sleep last night, which I thought was a bonus. That never happens in Manchester, especially if you're on a city truck. Nevertheless, I'm still tired. And I'm off to bed. I will write more about the Boston adventures later on.

3 comments:

EE said...

Just checking in, haven't talked to you in awhile.

I hope all is well.

manchmedic said...

Things are good here, just busy. How's the progeny?

EE said...

Glad to hear.

It's ok.