Thursday, August 28, 2008
Sunday, August 24, 2008
ED Thoracotomy #2 this week
So I'm driving in to round on Sunday morning, and I'm about two minutes from the hospital hen my pager lights up: "Code 1 GSW abdomen"
I get to the hospital, cruise down to the trauma bay, and the on call resident is opening the chest. I throw a gown on and help out. We get a weak, thready pulse back. Off to to OR.
On the way, we pass the family in the hallway. They are (understandably) going nuts. We get to the OR, can't identify any bleeding in the thoracic cavity, and decide to open the belly. Blood gushes out (despite our clamped aorta). We lose our pulse. Quickly mobilize the left colon/kidney/spleen, and find a huge aortic injury.
We try and resuscitate/repair, but to no avail. Patient expires.
When my attending tells the mom, she runs out of the hospital and has a seizure. Luckily, she is caught by another family member, or she would have been a trauma consult too, and thus on our service. I feel a little guilty that instead of feeling bad for her, I was happy that she was caught so that I wouldn't have to admit and round on her.
Sometimes, cleaning up the list seems to matter a little too much to me. I'm not sure what that means, but there it is. Anyways, we're 1 for 2 in lifesaving thoracotomies this week.
I get to the hospital, cruise down to the trauma bay, and the on call resident is opening the chest. I throw a gown on and help out. We get a weak, thready pulse back. Off to to OR.
On the way, we pass the family in the hallway. They are (understandably) going nuts. We get to the OR, can't identify any bleeding in the thoracic cavity, and decide to open the belly. Blood gushes out (despite our clamped aorta). We lose our pulse. Quickly mobilize the left colon/kidney/spleen, and find a huge aortic injury.
We try and resuscitate/repair, but to no avail. Patient expires.
When my attending tells the mom, she runs out of the hospital and has a seizure. Luckily, she is caught by another family member, or she would have been a trauma consult too, and thus on our service. I feel a little guilty that instead of feeling bad for her, I was happy that she was caught so that I wouldn't have to admit and round on her.
Sometimes, cleaning up the list seems to matter a little too much to me. I'm not sure what that means, but there it is. Anyways, we're 1 for 2 in lifesaving thoracotomies this week.
Tuesday, August 19, 2008
Things I only saw on bad TV shows
I used to watch the TV show "ER", and "Trauma: Life in the ER". Nowadays, I really wonder why I wanted to watch a show about work.
Anyways, I got to participate in an ED thoracotomy today (The 3rd one in 6 weeks here). A guy took a sawed off chotgun blast to the leg and back. He had an obviously catastrophic leg injury, but he coded twice during the resuscitation. We had yet to even roll him over to look at his back because we had airway issues and needed a Cordis. Right when we flipped him and noticed holes in his back/neck, he lost vitals, so we cracked his chest.
It was awesome. Did internal compression until his heart started beating again. He had a pulmonary laceration that was bleeding pretty good, so we whip stitched it and ran to the OR. Gave him a wedge resection, tons of blood, and cut off his leg. (And you thought you had a bad day.). First pH in the OR was 6.6.
Good news is, he awake and alert in the SICU. He'll probably get ARDS, but he's alive for now. Pretty freaking awesome day. Then I had to go to stinking clinic, and be the king of Vicodinland for the afternoon. All in all, a good day.
Anyways, I got to participate in an ED thoracotomy today (The 3rd one in 6 weeks here). A guy took a sawed off chotgun blast to the leg and back. He had an obviously catastrophic leg injury, but he coded twice during the resuscitation. We had yet to even roll him over to look at his back because we had airway issues and needed a Cordis. Right when we flipped him and noticed holes in his back/neck, he lost vitals, so we cracked his chest.
It was awesome. Did internal compression until his heart started beating again. He had a pulmonary laceration that was bleeding pretty good, so we whip stitched it and ran to the OR. Gave him a wedge resection, tons of blood, and cut off his leg. (And you thought you had a bad day.). First pH in the OR was 6.6.
Good news is, he awake and alert in the SICU. He'll probably get ARDS, but he's alive for now. Pretty freaking awesome day. Then I had to go to stinking clinic, and be the king of Vicodinland for the afternoon. All in all, a good day.
Wednesday, August 13, 2008
A new title for the blog.
Because The BackRight was a lame name that came to me when nothing else would, this blog was so titled.
But no longer.
Let it be dedicated to the veterans (and brothers in spirit) of the Conshohocken Convoy, many of whom suffered (and still suffer) from Hotpocket Fever. Symptoms include an irresistible desire to drive over rumblestrips and a craving for red beans and sausage.
It is rumored that brother Jason Caywood still has loose stool from said disease, and brother Shane Taufer might be dead.
But no longer.
Let it be dedicated to the veterans (and brothers in spirit) of the Conshohocken Convoy, many of whom suffered (and still suffer) from Hotpocket Fever. Symptoms include an irresistible desire to drive over rumblestrips and a craving for red beans and sausage.
It is rumored that brother Jason Caywood still has loose stool from said disease, and brother Shane Taufer might be dead.
Friday, August 1, 2008
Paging "the guy called" Dr. Lohman
Rhett, I don't know what kind of internet "scheme" you have going, but my wife just got this post on her blog a few days ago:
"Hi Anne, you don't know me, my name is David, I live In Spain where the guy called Rhett Lohman was serving a mission. I have tried to find him for more than 10 years! He was serving in the Santa Cruz branch. I don't know if he remembers me but please, give him my email if you can, I would be eternally grateful.
bubuni08@gmail.com "
Can you please ask "BUBUNIO" to stop emailing my wife!
"Hi Anne, you don't know me, my name is David, I live In Spain where the guy called Rhett Lohman was serving a mission. I have tried to find him for more than 10 years! He was serving in the Santa Cruz branch. I don't know if he remembers me but please, give him my email if you can, I would be eternally grateful.
bubuni08@gmail.com "
Can you please ask "BUBUNIO" to stop emailing my wife!
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