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March 30, 2006
neat thing
last night was my last call night as a medical student.
it was neat cause abby was on the team so we got to spend some quality call time together.
at around 5am the code pager went off, scared the bejesus out of abby and i as both of ours were going off at the same time and really frickin loud.
we get down to the MICU and a guy is getting chest compressions and being bagged, this stuff of course excites me, so i take my coat off and put gloves on and get put to work doing chest compressions.
so, push, push, push CRACK, yes that is right, i broke the shit out of something in his chest (could have broken off his xyphoid process, could have broken his sternum, most likely broke ribs). so do compressions, when the bed is at an appropriate height compressions were actually easier than i expected, however, there is a very narrow window of 'appropriate height', the bed went up 2 inches and i immediately thought my back would break.
the intern took over and the guy went into v tach (from asystole)-->the theory the intern and i have that we enjoy is that i broke off his xyphoid process and hassan was shoving it into his heart and irritating it into vtach 8)
anyway, vtach can be shocked, and shocked he was! 3 times.
after that he went into supraventicular tachycardia (this is a reasonable rhythym, meaning just fast, so we let that go).
SO, the MICU intern went to try to intubate him, however he had blood welling up in his mouth (he was in the ICU for a perfed duodenal ulcer for which he is not an operative candidate). She tried to intubate him and got into his stomach....while this was going on I was looking for a gown and mask and face shield which was difficult, knowing that I was next on the intubation block.
Took forever! Can't find anything down there!
Anyway, they took the tube out and bagged him, I got up there and they had a tube but no stylette, no syringe and no end tidal CO2 detector. It took FOREVER to get these, so I finally got what I needed (another weird thing, they lubricate the ET tubes...). So I put the laryngoscope in and the respiratory therapist is trying to help by tilting his head, however he was tilting the head and squishing on the guys throat and obscuring my view. So I ended up yelling at him too....It was jsut frusturating, I ended up yelling at several people just trying to get things done!
ANYWAY, I got good visualization of his cords and got it in on the first try.
The end tidal was slow to change color, I suspect this was because he had aspirated a ton of blood and didn't have room to move air. ANYWAY, he was satting low (60-77% after being intubated), so he needed an ABG, which I offered to do and got.
ANYWAY, got that was awesome! It indicated to me that ICU is my thing.
In the elevator back up to the call rooms after the code with Tiffany, Abby and Hassan they were givin me a hard time, saying that it was my MICU (I also intubated a guy who was laryngospasyming on our last call on the 1st try), that they should put pictures of me, smiling holding a laryngoscope in all of the rooms.
Hassan said to me later "you should carry around a laryngoscope in your pocket at all times man, cause you, like, have the power to save anyones life at any time man...."
It was just funny and neat.
I love that type of stuff, the acute things, the things that make a real difference....
Well, that being said, the guy should have died days ago and will probably die shortly, he was still alive when I left at noon, and he SHOULD have been DNR.
ANYWAY, neatness.
Posted by Maggie at 8:22 PM | Comments (3)
March 24, 2006
match
for those who were unaware of my rank list (which would be most people)
my first choice was university of cincinnati for anesthesia.
it is one preliminary year (which for this program is 6 months of internal medicine, 3 months of surgery, 1 month of ER, 1 month of anesthesia and 1 month of vacation)
then 3 years of anesthesia.
after those four years, i think that i will likely choose to do a fellowship in critical care medicine (ICU doc), but that is quite some time from now when i will make that decision.
BUT YAY for matching in cincinnati!!!!!
Posted by Maggie at 8:22 PM | Comments (0)
March 14, 2006
MATCH
So, I matched.
And because of a remarkable snafu (which I will not go into) I know where (which was one of my goals).
So, that is exciting!!!
I was initially told that I didn't match except for a first year position, which would mean I had to scramble, I found all of this out when I was on call, which SUCKED, and our call team got SO owned last night, it was one of our worst calls, I got 2.5 hours of sleep in like 1 hr and 1.5 hour increments, I was in a shitty mood, I had to leave early, I was bawling and this morning an hour and a half before I had to begin scrambling I got a call and was offered a position at my first choice institution. I was the next person on the match list and someone else withdrew.
Anyway, there is a little more minutae but my understanding is that I "matched" I was never unmatched...yeah, I don't quite know what happened, but it turned out well!
Posted by Maggie at 7:07 PM | Comments (3)
March 6, 2006
RAZR!!
I GOT A RAZR TODAY
and a bluetooth headset
my life feels fufilled
also, last night was a neat call night, i personally capped at midnight so i got to sleep for 3-4 hours, the rest of my team was not capped and was hella busy.
if i hadnt had the hella busy night our previous call night while at least the other ai was sleeping i probably would have felt more guilty....
ok, i will probably post a pic of myself with my phone, it makes me feel happy!
Posted by Maggie at 7:52 PM | Comments (2)