I just got off a P shift (7p-7a) It was awful. Started off slow but I got a "stable GI Bleed". He was in another ICU but came to our CCU b/c of bed issues...whatever.. doesnt matter
My question to you all is do you ever leave a real busy pt and just feel like you wish you could do things faster??? I had him 1:1 but that wasnt even enough. I actually only had him from 3a-7a. Anyway, he got to us, not bleeding.... bp started to drop, started to get real tachy, ab distended..... ng heme pos but not gross at this point... page intern bc bp is 50/30..tells me to bolus him with whatever (dont you love those orders) give him 2L still bp in the toilet page him again..say hey, i think hes going in to shock, bleeding somewhere.... intern wont listen... dont worry just give him more fluuds.............. half hr later pt has blood frank blood emesis... great... now i know im in trouble...ask him if we can intubate....says no not now want to hold off (i am ready to shoot him...bp is still crappy
well to make a long story short he got about 6u prbc, 5u ffp, 3L NS, levo maxed dopa maxed bp still 90 ...tachy to 130. when i left his hemoglobin was 4.8
he did end up getting intubated.... 4inches north of the carina though (intern insisted on intubating rather than anesthesia)
anyway, i just feel luike i wish i could have done more...feel like there was more i should have done...do u ever leave work feeling like a failure, feeling so bad about ur night????
i keep on replaying things in my mind, wishing i could have been faster, should have done this... ahhhh what do u do to get it out of ur mind... !!!!!!!!!!