Tuesday, January 29, 2008

Stat!

"Staff Stat to OR Z"

Hmm.... not good. usually.

This is an alarm system we have so if there's anesthesia emergency and the staff is not in the room, the resident or a nurse can call overhead on the speakers and everyone available can come to the room to help whomever is in there.

Sometimes it's only a false alarm, the patient's oxygen level is reading a little low and the resident gets a little worried.

Sometimes it's much worse.

"Staff stat to OR Z"

I shuffle quickly over there.

I walk in, they are doing chest compressions. Apparently the patient "crashed" about 10 minutes after the start of the case.... low blood pressure of uncertain origin, didn't improve with treatment at all so they started CPR (Cardio Pulmonary Rescusitation). Emergency drugs were given.... epinephrine, atropine, all the good stuff.

After about 15 more minutes after I arrived, they called it, meaning they pronounced the patient dead, all attempts unsuccessful to resuscitate failed. The anesthesia staff in charge of the case don't know what the issue was... the patient was "relatively" healthy. Definitely will need an autopsy to see if anything obvious shows up.

Anyway, we all shuffle out, mostly feeling defeated a little.

Ten minutes later,

"Staff stat to OR 10"

Weren't we just in there?

I head back over there. They're doing chest compressions again.... apparently they were cleaning up the room and filling out the death packet and they saw some rhythm on the monitor so they felt they should give it another shot. Although in the meantime, they hadn't been ventilating the patient or watching the patient since she were pronounced dead. (why would they?)

We persisted a few minutes and then we all decided that it was probably futile... some sort of agonal near death heart reflex (which often happens).

We all left the room again... though not before I disconnected the monitor.

Sadly we can't win them all.

Friday, January 18, 2008

Computers down!



Went to a doctors appointment today. I usually go at 8am. The doctors tend to run behind and if I'm the 1st patient of the day they can't be behind. Anyway, the doors are usually unlocked at 7:45 or so. I pull up and there are three or four people milling around the door. At about 8 they open the door. I walk in and try to check in. Apparently the computers and phones were down. They couldn't check me in, they couldn't put me in a room. Fifteen minutes later, they put me in a room and found some forms to manually check me in. The doctor comes in a few minutes later, he's obviously flustered.

How are you doing? Did they check your sugar today? No of course not, the computer would have told them to do that. Sorry we have no chart, we're all paperless now. What was your last Hgb A1C? your memory is better than mine... an altogether unsettling visit. He's a really good doctor and actually remembered a lot off the top of his head.

Funny how relient we are on computers in the medical field these days. I know I couldn't do my job very well without a computer

Oh, Happy New Year