Rotation IV, Emergency Medicine: I didn't puke!
I walk into the 2W pharmacy satellite. It's 9AM. I sit down and meet my preceptor, John. He tells me he's going to give me a quick overview of the rotation. He says, "Mike, what we do he-" His pager goes off. "P1, pt unresponsive, SAH - ok, let's go."
Confused, I follow him to the ER, up a floor - jogging the whole time. I get up there and there is this lifeless woman laying in an ER bed, residents, nurses, physicians, respiratory therapists, anyway, an assorted crew. My preceptor looks in and goes, need some manitol, nimodipine?
We run back up two flight of stairs to the main pharmacy, gab some vials of manitol, 60mg of Nimotop, and we are on our way back down a flight of stairs. On the jog back down, he looks back and asks me what manitol and Nimotop do. I actually knew the answer.
So back down two flight of stairs. We get down there, they are moving her around, doing all sorts of physical examinations. My preceptor tosses me a vial without even looking at me, "Draw this up, now!" It's like the manitol seemingly instantly gave her a bit of life. I though it was cool. They take her to the CT room.
About 1/2 a second later another page comes over, "Ok, Mike, DKA, P2, ETA 5min." He calls the pharmacy and instructs them to make a standard DKA insulin recovery drip. "Mike, remember where the main pharmacy was? Go, now, and grab that bag they are making." Up two flights, grab bag, down two flights.
As they take the insulin from me, my preceptor takes me to the CT room to show me the scans. A subarachnoid hemorrhage is one of the worst things that can happen to you. "See all that white stuff covering about 1/4 of the right side of the brain? Yeah, that's bad." The neurologist did a "voodoo math trick" of his to figure her odds of mortality was roughy 1. She was deemed clinically brain dead by the next morning.
So THEN another page comes in as the CT wraps up. "Ok, Mike, P1, Car vs. Tree/ MI, 35m, vsu, ETA 15min. We gotta grab the crash cart, buddy.""
My preceptor runs back over to the ER and starts preparing epi, atropine, NaBicarb, and calcium syringes. The attending physician is there, about 20 students and residents, surgery, radiology, I think a bartender for some reason. It was a packed house. About 12 minutes until the fella got there. Then the senior surgery resident comes up to my preceptor, "John..I feel like a complete ass asking this...but can I borrow your student?"
Long story short, she was wearing heels and needed her tennis shoes she had up in her on call holding cell. As the most useless person there, it was my job to grab her shoes. Said on call holding cell with shoes was on the 9th floor on the complete opposite ass side of the hospital. So...up 6 flights of stairs, run across hospital....grab shoes...run back across hospital...go down 6 flight of stairs. I got there before the trauma. Good for me. I guess.
The guy comes in..I guess he had a nasty MI, then crashed his truck on the interstate. He died on the ER bed. They still haven't officially figured out which was the actual cause of death.
So my first hour in this place, I've ran up more steps than I can count, witnessed two people die, and become the bitch of a surgery resident. Productive day.
The first day was nutso. The others were slower, so we got chances to go over whatever diseases or treatments I wanted to go over. The previous bitching about the US education system was uprooted with this rotation. During down time, we just shot the breeze. We talked about everything from WVU football to the new Crohn's drugs.
Honestly, this was one hell of a worthwhile rotation. Every day I learned something new. Anybody who goes to WVU - I HIGHLY recommend it. It's not for the squeamish though. When I saw an open wound on a girl above the elbow about the size of a football with the bone exposed and broken in half, I about hurled. If you drive down the interstate at 75MPH, don't stick your arm out the window.
Next rotation is at Preston Memorial Hospital in Kingwood, WV.
THE COMMENTS PAGE!!!®
Positive comments:
Mike is a very intelligent individual. He possesses great knowledge in the field of pharmacy AND utilizes various references effectively to determine appropriate care/dosages of medications in the acute care setting.
Critical comments:
None
Misc verbal comments (I'm not making this up): Mike, you need to get tested for ADHD, I can tell you have racing thoughts. You need to get that squared away before you take those faculty rotations you have coming up. Get checked out.
Confused, I follow him to the ER, up a floor - jogging the whole time. I get up there and there is this lifeless woman laying in an ER bed, residents, nurses, physicians, respiratory therapists, anyway, an assorted crew. My preceptor looks in and goes, need some manitol, nimodipine?
We run back up two flight of stairs to the main pharmacy, gab some vials of manitol, 60mg of Nimotop, and we are on our way back down a flight of stairs. On the jog back down, he looks back and asks me what manitol and Nimotop do. I actually knew the answer.
So back down two flight of stairs. We get down there, they are moving her around, doing all sorts of physical examinations. My preceptor tosses me a vial without even looking at me, "Draw this up, now!" It's like the manitol seemingly instantly gave her a bit of life. I though it was cool. They take her to the CT room.
About 1/2 a second later another page comes over, "Ok, Mike, DKA, P2, ETA 5min." He calls the pharmacy and instructs them to make a standard DKA insulin recovery drip. "Mike, remember where the main pharmacy was? Go, now, and grab that bag they are making." Up two flights, grab bag, down two flights.
As they take the insulin from me, my preceptor takes me to the CT room to show me the scans. A subarachnoid hemorrhage is one of the worst things that can happen to you. "See all that white stuff covering about 1/4 of the right side of the brain? Yeah, that's bad." The neurologist did a "voodoo math trick" of his to figure her odds of mortality was roughy 1. She was deemed clinically brain dead by the next morning.
So THEN another page comes in as the CT wraps up. "Ok, Mike, P1, Car vs. Tree/ MI, 35m, vsu, ETA 15min. We gotta grab the crash cart, buddy.""
My preceptor runs back over to the ER and starts preparing epi, atropine, NaBicarb, and calcium syringes. The attending physician is there, about 20 students and residents, surgery, radiology, I think a bartender for some reason. It was a packed house. About 12 minutes until the fella got there. Then the senior surgery resident comes up to my preceptor, "John..I feel like a complete ass asking this...but can I borrow your student?"
Long story short, she was wearing heels and needed her tennis shoes she had up in her on call holding cell. As the most useless person there, it was my job to grab her shoes. Said on call holding cell with shoes was on the 9th floor on the complete opposite ass side of the hospital. So...up 6 flights of stairs, run across hospital....grab shoes...run back across hospital...go down 6 flight of stairs. I got there before the trauma. Good for me. I guess.
The guy comes in..I guess he had a nasty MI, then crashed his truck on the interstate. He died on the ER bed. They still haven't officially figured out which was the actual cause of death.
So my first hour in this place, I've ran up more steps than I can count, witnessed two people die, and become the bitch of a surgery resident. Productive day.
The first day was nutso. The others were slower, so we got chances to go over whatever diseases or treatments I wanted to go over. The previous bitching about the US education system was uprooted with this rotation. During down time, we just shot the breeze. We talked about everything from WVU football to the new Crohn's drugs.
Honestly, this was one hell of a worthwhile rotation. Every day I learned something new. Anybody who goes to WVU - I HIGHLY recommend it. It's not for the squeamish though. When I saw an open wound on a girl above the elbow about the size of a football with the bone exposed and broken in half, I about hurled. If you drive down the interstate at 75MPH, don't stick your arm out the window.
Next rotation is at Preston Memorial Hospital in Kingwood, WV.
THE COMMENTS PAGE!!!®
Positive comments:
Mike is a very intelligent individual. He possesses great knowledge in the field of pharmacy AND utilizes various references effectively to determine appropriate care/dosages of medications in the acute care setting.
Critical comments:
None
Misc verbal comments (I'm not making this up): Mike, you need to get tested for ADHD, I can tell you have racing thoughts. You need to get that squared away before you take those faculty rotations you have coming up. Get checked out.
posted by --==-- | 10:52 PM
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