Scary

I'm on the overnight pediatric shift in the ED tonight for Halloween. Wonder what we'll see....

Recovering from sudden death

Recently I've been involved in the care of two patients who were in the hospital after dropping dead. Literally.

In each case there was somebody on the scene who started CPR almost immediately. They were taken to the intensive care unit, treated with a cooling protocol, and are now able to look forward to resuming their lives with intact personalities and nearly intact physical functioning. And although they received interventions that didn't even exist all that many years ago, the reason that both of them are now able to spend time with their families is that when they hit the floor someone was able to start chest compressions.

During morning rounds on one of them it was mentioned that the patient was somewhat confused and emotional. The attending physician commented "that's okay, it's expected; she's still recovering from her sudden death."

One lump or two?

These days I've been rotating on Cardiology at the county hospital. Call nights require careful planning, because the cafeteria closes at 7:00 pm and that's it for food or drink (think coffee) for the rest of the night. So the other night I managed to make it to the cafe at 6:55 and stocked up with a couple of bottles of Gatorade, an apple, and a cup of sweet, consciousness-giving cafeteria coffee. As I'm balancing all of this in my hands and heading back to the resident room there's only one obstacle in my way -- a door with a security keypad. I managed to punch in the code with my free pinkie, but the weighted door swung back into my other arm, launching half of my coffee onto the shoulder of my white coat, staining my reference books and patient notes brown, and soaking through my scrubs underneath. I quickly cleaned up as best as I could, desperately hoping that the code pager wouldn't go off while I was half undone, but I was stuck with a warm, moist spot, a huge brown stain on my coat, and a lingering coffee aroma for the remaining 17 hours of my call. By the end of 30 hours of call I'm never feeling too fresh, but I was particularly bedraggled by the end of that one. The worst part was that every time I talked to a consulting doctor, a nurse, or a patient, they stared at my shoulder, no doubt wondering what vile body fluid had splashed on me.