As usualy I have 2 patients and geteing a third from the ER. 2 Stable, one a big mi and the other resp distress, mi is a herion addict, resp distress is mr and schiz, i never gte the "normal" patients. Anywho report taken by day shift is another rest distress, 350 lbs, thye supposedly stuck him 15-20 times for a line and couldn't get one it. I made the tupid assumption that they put a cvp in, wrong!!! ANyhwo i get him settled, he's a&o gets off the cart into bed, pox 64%, put him on a 100% nrb sats up to 100%, change to nasal bipap that he wears at home, and get a 20 ga in one stick, I would of called the er to rub it in but my noght gets worse ( or better, i like being extremly busy wiht crashing patients). ANy who i do a gas and it sucked somnting like 7.29, 89, 125, 19, and he's real lethargic. "Bill" (intern on call) I'm calling anesthesia and were tubing him now" Intern goes in the room and arouses him and changed to a full face mask instesad of the nasal and he shooded anesthesia away. Doa gas an hour later and it's worse somthing like 7.19, 100, 155, 34. while this is happeneing next room is coding, she didn't make it, not mine thankfully. This guy is barley arousable by smaking his big ole belly, not following command... "were tubing him NOW, I really dont care what you say, anesthesia resident is back and *****y, she's a big whinner, and her fitrst question is "how uis his k+", who cares, he can't breath, tube him, half an hour later "I think you need to call the attending" and sends some one for the fiber optic, still cant get him Attendin one gets there after switching place with the resident cuz she just startd a transplant case, she works him for an hour, intubated thje stomach once, attending two happen to come in for a nother case, he tubes the stomach, than the trach, but we dropped the ng down the et tube in the stomach, funniest looking thing. This was all before midnight! We stabile him and sedate mhim 30 of fentanyl, 30 of versed and they want vecuronium, we all 3 aint compatable, tell the rez this, and i need a cvp, well i got one , at 4 AM!!!!!!!!!!!! Luckily my other 2 patients weres stable, and the nurse who had the code that didn't make it took the resp disress for me and ve diverted any hits to the SICU!!! ANyway damn good think i was able to get that one line in, !!!! That really annoyed me that they didn't put ione in! Thanks for listening
Oh yeah we called surgery to do an emergncy trach just in case, so the whole time they're waiting buouncing up and down like a 5 year old on christmas eve, waiting to put on in, I think they were a little bummed they didn't get to do it.
