I can officially say I save lives now

This was written a few days ago while I was on call.  I’d changed the phrasing but I like the way it reads now.   Enjoy:

I was finishing up some work about a half hour ago and checking scores on the day’s games when “Number 1 Emergency – Adult, 687 East” came out across the PA system. I was already on the 6th floor so I ran to the other side and as I spied the room with all the activity I went to see if they needed another set of hands. The 3rd year senior resident had me run to find a central line kit. As I came back, he found out that the patient had a portacath for her chemotherapy (the patient was on the Oncology service, while the senior resident was in the Intensive Care Unit). A portacath is just as good as a central line, so there was no reason to put one in. I locked eyes with another intern to see if she needed any help. She asked me to rotate in on CPR. I jumped in and got to work, crushing this poor woman’s small, fragile rib cage. I’m always worried about crushing someone’s chest, even more so this time. I guess it was apparent to the senior because he told me to press harder.

In the middle of my 2 minutes of chest compressions we were giving epinepherine, a drug that increases blood pressure which helps push more blood to the brain and stimulates the heart to start beating again. We also give atropine, a drug which blocks any slowing input to the heart. At some point, I was asked to stop compressions so they could check for a spontaneous heart rate. Suddenly a relatively normal heart rhythm appeared, almost from nowhere, on the monitor and it began to chirp away. Her blood pressure came up and she had a palpable pulse again.

We found out that she was an oncology patient who had her esophagus and stomach scoped earlier today by the GI service. Shortly before we arrived, she had suddenly vomited and then lost consciousness. Fortunately, an anesthesiology resident was around and she was quickly intubated to help with her breathing and protect her airway from any further vomitus from traveling down into her lungs.

One of the 2nd year residents placed an arterial line in the large artery in the thigh, so that we can get second to second monitoring of her actual blood pressure. It’s much more precise than relying on a blood pressure cuff. We ordered several lab tests to check her heart enzymes and blood gas and to check for infection. She’ll get several high potency antibiotics to help protect against the likely pneumonia she’ll develop from aspirating vomitus into her lungs.

Honestly, she’s a pretty sick lady and might not make it much longer no matter what else we do tonight. I don’t say that to sound defeatist… I say it because it’s the truth. We can’t pat ourselves too hard on the back for this one. I’m glad we’re giving her a fighting chance and I hope that she pulls out of it. But at least when my wife or parents ask “Did you save any lives today?” I can say “Yeah… actually I did.”

I won’t lie… it’s pretty damn cool.