Night shift was awful/awesome (delete as appropriate depending on clock-reading).
2100hrs - 80YOF - allergic reaction to angio dye. Massive hives for 3/7, then reacted to first dose of prednisolone - swelling of face, limbs, etc. Unreadable Sp02 to start with, but was fine on 02.
2200 - Miles out into the countryside to an 80YOM - off legs. Ca lung, smoking like a chimney. Didn't want to go to hospital cos they wouldn't let him 'sneak out for a fag'. 45 min handover at hosp = lifestory of every hospital escaped from to have a fag. Giving the nurses hell when we left...
0000 - 17YOM - transfer to our local hospital. Car V Ped, knocked out by wing mirror. #base of skull, orbit, ankle. Beautiful 'eye-shadow' bruising. Talked like a steam train all the way in.
0130 - did something. Night shift amnesia. [EDIT - standby at far-north station. Woke me up a bit, having drifted off several times on the drive, whacking my nose and chin on various metal boxes arranged around my seat. Didn't spend long there, as got sent back to hospital to stand-by there]
Slept from 0230 til 0400.
0430 - 50YOM - constipation. Excruciating pain, relieved on Entonox. Learnt that taking a patient to A&E pain-free (due to morphine, etc) means no treatment.
0530 - 71YOM - Multiple convulsions. Evidence of CVA. GCS 3 on arrival at scene. Massive fit on loading into the truck. Stopped without pharm intervention. BVM 02, switched to face mask for transport. Cannulated. Rang ahead to A&E to prep resus. 2mg lorazepam on arrival as starting fitting again. Another line in. U&E, FBC, Clotting, Group&Save bloods, and ABG done. OPA inserted as decerebrate-ness (?) implied inability to hold own airway. ABG came back as acidosis (6.9) - no idea whether resp/met, but prob resp as COPD? Dunno, all first year exam material has gone. Pupils fixed/dilated. Shit prognosis. Bit of an oxymoron on quality of life - lived in complete squalor, but was king of his castle. Could get around fine normally, only seen by 999 every few months for COPD (another insistent smoker!). I think the para's were sad to see him at his end - the "cantankerous old git"s are sometimes highlights of the day/night.
I hung around in resus for quite a while (not entirely sure whether this was out of medical student curiosity or the hottie F1 - shame on Jelly). Got some awesome teaching off the F1 too, about basic management, assessment of GCS, analysis of ABG results, etc.
It was a strange shift, overall. A great end, experience-wise, in terms of it being the only blue-light run into A&E I've witnessed, with treatment en-route, and teaching too, but obviously a shit end as well. I daren't inquire as to how the guy is, cos I already know the answer, and I don't like it.
Why do I want this career so much?
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment