ER Observation 2

Hello!

Today (3/14/13) I did my second day of shadowing in the ER. Same doctor, same hospital, but a whole lot more chaotic. Well maybe not a whole lot but definitely more eventful for me in regards of procedures.

The main thing that stands out in my mind is the code that came into the ER. I know this sounds really bad, but before I went for my first day of shadowing, I told my friend that I kinda wanted someone to code so I could see how a hospital tries to revive a patient. I guess I got my wish. . . in a really morbid way. I was with the doctor in a patient room getting a better history on a patient that came in due to lack of consciousness and some chest pain. Out in the hallway was some yelling and a gurney with a doctor doing compressions. One of the other doctors came in and asked if he could steal me and led me to the room where they were trying to revive the John Doe who came into the ER in cardiac arrest. The main difference I noticed from a code in real life and a code on TV is the speed of compressions administered to the patient. While on TV, it does appear rushed and urgent, it doesn't come close to the extent in real life. In order to revive a patient and continue blood profusion to the brain, you need to do 100 beats in a minute and those doctors/nurses/transport did a good job doing compressions at about 121 beats per minute. It was also exciting for me because I got to help slightly. If they needed more gloves, I got them gloves. I opened and prepared epinephrine when the nurses arms were full. And finally I held an IV pump so that fluids would be administered. Also, the whole rubbing paddles together and shocking the patient with 300 joules of electricity doesn't happen anymore. They have a defibrillator that delivers the shock for them and it only goes up to 200 joules. They did get a sinus rhythm for about 5 minutes but never got a strong pulse and eventually lost the rhythm. Sadly, they eventually decided to stop and call it.

In comparison, the rest of my day was a little uneventful. Rather than a theme of abdominal pain like Monday, today's theme was shortness of breath. Other than that I watched an echocardiogram done and and abscess removed.

I guess upon my immediate reflection of my shadowing at the ER, I realized I can handle the blood, stool, and puke that comes with being a doctor. All in all, this was a success.