Monday night, 10 pm, on call. While rounding in another part of the ICU, my intern gets a page that one of our post-op patients is desatting. She desatted earlier in the day, but we got her back with aggressive suctioning, so my intern leaves to try this out. 2 minutes later, I walk in.
Me: Whoa, she's down to 78%? That's worse than before... and her pressure's dropped!
Intern: Oh, yeah.
*my friend E, the medical resident on that evening, walks in with his intern*
Me: E! Oh, thank god. Listen, she desatted earlier but we got her back with suctioning. I'm going to bump up her O2 and attach this ventimask while I suction her. Wait, that's not a ventimask... do we have anything else?
Nurse: Can't you see that I'm BUSY?! (Gets back on phone)
E: Ok, let's get a second O2 sat monitor, this thing is jumping around and I'm not sure if it's working.
Me: Great idea. Hmm, this really isn't getting better. I'm going to sit her up.
Intern: She's only satting 60% now, on this new machine. And her pulse just dropped to 50.
E: *listening to chest* Nurse, page respiratory - we need a proper mask. She's not getting adequate ventilation here.
Me: *nearly hysterical* Holy shit, her sat's now 50%.
E: *silent*
Me: *silent*
Us: *simultaneous realization that two 2nd year residents are in charge and nobody more senior is coming to help us* Uhhhhhhh.....
*300 years pass*
Respiratory: Did someone page respiratory?
Us: OH THANK GOD YES SHE NEEDS TO BE INTUBATED RIGHT THIS VERY SECOND OH GOD OH GOD OH GOD!!!
Respiratory: Ok. Move. *Intubates*
Me: Mrs. Jones? Can you hear me?
Mrs. Jones: *big smile*
Sarada's Ass: Wow, I don't think I'm going to be able to pass stool for days now.
Me: Whoa, she's down to 78%? That's worse than before... and her pressure's dropped!
Intern: Oh, yeah.
*my friend E, the medical resident on that evening, walks in with his intern*
Me: E! Oh, thank god. Listen, she desatted earlier but we got her back with suctioning. I'm going to bump up her O2 and attach this ventimask while I suction her. Wait, that's not a ventimask... do we have anything else?
Nurse: Can't you see that I'm BUSY?! (Gets back on phone)
E: Ok, let's get a second O2 sat monitor, this thing is jumping around and I'm not sure if it's working.
Me: Great idea. Hmm, this really isn't getting better. I'm going to sit her up.
Intern: She's only satting 60% now, on this new machine. And her pulse just dropped to 50.
E: *listening to chest* Nurse, page respiratory - we need a proper mask. She's not getting adequate ventilation here.
Me: *nearly hysterical* Holy shit, her sat's now 50%.
E: *silent*
Me: *silent*
Us: *simultaneous realization that two 2nd year residents are in charge and nobody more senior is coming to help us* Uhhhhhhh.....
*300 years pass*
Respiratory: Did someone page respiratory?
Us: OH THANK GOD YES SHE NEEDS TO BE INTUBATED RIGHT THIS VERY SECOND OH GOD OH GOD OH GOD!!!
Respiratory: Ok. Move. *Intubates*
Me: Mrs. Jones? Can you hear me?
Mrs. Jones: *big smile*
Sarada's Ass: Wow, I don't think I'm going to be able to pass stool for days now.
Oh, I know that feeling. I ran to a code today thinking "Shit, I'm in charge. Shit. Shit. Shit."
ReplyDeleteNow -that- sounds familiar... What is it with desatting at strange hours when none seriously educated is around or willing to wake up?
ReplyDeleteOh WOW!! Man...only in medicine.
ReplyDeleteYeek!
ReplyDeleteAlso, that nurse's attitude sucks. I know they have their own duties to attend to but surely a near-code situation trumps whatever she was doing?!