Thursday, October 16, 2008

PVC Challenge

Clinicals continue to entertain.

I'm way behind in my clinical paperwork... as soon as I finish posting, I've got to work on my charts for my ED shift last week, as well as my prehospital shift on Sunday. If I get all caught up, there is paperwork from the L&D rotation to do, too.

Anyway... the other night was a pretty busy shift. Started off with a major trauma after an MVA. BLS onscene called for us to assist. Patient had a femur fracture and signs of a head injury... so he got himself a ticket for a helicopter ride to the nearest trauma center.

I had a few other calls, but the last one was the most serious:

Dispatched for a CVA (Stroke). On arrival, the usually calm cop was a little panicked. PD said that the patient had just gone unresponsive on him after exhibitng sudden-onset, stroke-like symptoms.

The patient wasn't breathing well... fast, shallow, irregular respirations. We laid the patient down and he wasn't moving air and had signs of a brain injury, so we went for the airway.

After ventilations with a BVM, the patient started to look better. Gag reflex was intact, so I intubated nasally. I'd always head how easy it was... but I didn't really believe it. I had a little trouble at first, because I had to remember to push the tube BACK, not up. I was using a BAAM (a whistle that fits over the end of the ET tube), and all of a sudden, it started whistling. I checked lung sounds and secred the tube.

I was a little protective of the tube... because I didn't want to lose the tube.
Part of that reason was that I'd pulled a medic's tube out on my last prehospital shift... the tube just popped out... and I wanted to make SURE it didn't happen to me.

So... I got another first in the class. Someone else got the first oral tube... but I'm the only one with a nasal tube.

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