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- Oct 13, '10 by GoldenFire5Quote from canesdukegirlThat is a real life "there is a fracture, I need to fix it" story.Oh yeah-"Hello V-Tach!" So I alert the surgeons to stop reaming. The new resident is fumbling around like a fish out of water. I immediately page the anesthesia attending-doesn't show up. I am helping the anesthesia resident draw up meds, got the crash cart, starting putting on the pads. The surgical attending stops me and says, "This is not part of your job. You are the circulator. You are supposed to help the SURGEONS. You need to stop being so controlling." I just looked at him and kept going. The anesthesia attending still has not shown up. I go out into the hallway and snag the cardiac anesthesiologist. She immediately takes over and we shock the pt into a normal rhythm. The cardiac anesthesiologist says to me in a loud voice, "You picked up on the v-tach in time, and your swift actions directly impacted the outcome of this patient. Thanks girl!"
- Oct 13, '10 by VivaRNI think my best "save" so far was a walk-in patient who came to clinic c/o dizziness.
She had a long hx of dizziness and had been dx'd with "low autonomic tone" by cardiology. I asked her all the standard dizziness work-up questions and she gave me nonsense answers. She basically said yes to everything (not very health literate). She couldn't answer me why she had come in with this today, when this was usually a chronic c/o for her. Her vitals were WNL. She wasn't orthostatic. I was perplexed.
Then I took a minute to look back in the chart. She was being treated with Ribavirin for Hep C. About a month ago, her Hep C provider had noticed some mild anemia and told her to decrease the dose.
I asked the patient if she had decreased the dose. She didn't know what I was talking about.
Did a STAT H&H - Hgb of 4.3, admitted her for transfusion.
- Oct 13, '10 by mustlovepoodlesI was working telephone triage for a children's hospital and took a call from some worried parents one night. The baby was 3 weeks old and "just not acting right." It was taking the bottle *okay* but not as well as before. It was sleeping more than before and crying differently than before. No coughing or congestion, no vomiting or fever. Nothing that just jumped out at me. The parents were totally focused on the feedings. Then the baby started crying and the mom picked the baby up while we were talking. I heard a barely perceptible wheeze. One wheeze. I couldn't really tell what was going on, but the parents were panicking and I had that weird feeling--you know, a 6th sense that something is VERY wrong. So I told them to take the baby to the ER for evaluation.
Two hours later I got a call from an outlying ER...
As they drove up to the ER door, the baby ARRESTED. The parents were screaming, the dad as frantically doing CPR, the nurses grabbed the baby and whisked it to trauma. Turns out that baby had a major, undetected heart defect! Within minutes they life-flighted the baby to the children's hospital and had it on the operating table 10 minutes later. Saved that baby's life.
- Oct 17, '10 by tvccrnQuote from 86toronadoI was on the recieving end of something similar once. In the ICU, the IMC calls for a guys post-cath that had fallen earlier. No c/o at the time, just a little lightheaded when up for the first time. About 4 hours later, get a frantic call that they are bring the patient over with a BP in the toliet.My favorite save would have to be when I was still a nursing student: Patient was just back from the cath lab, so we were doing Q15 minute vitals. BP is going down, not a whole lot, but enough to make it a little suspicious. Then the patient starts complaining of abdominal pain. I told the primary RN, who said she would call the NP "in a minute". In the meantime, BP is dropping more, and patient's daughter is getting nervous. I went to the charge nurse, who looked at the vitals, and called the rapid response team. Patient went to CT, found a retro- peritoneal bleed. Patient was transferred to CCU. BOOYAH!
Patient arrives and we start all the right meds for low BP with no response. Looking at the patient's back there is this "bruise" from where the patient fell earlier. HUGE bruise. I call the on-call for a stat H&H to no avail. Talk to the house supervisor who tells me to get it anyway. I do....6 and 20! Call the on-call and report the results, got the order for transfusion. CT the next morning shows retro bleeding.
Got wrote up for the effort, but an attagirl from the ICU manager behind closed doors.