I was totally jazzed coming home from work the other night, we don’t have true emergencies very often (though it seems to be happening more and more) days that we have true emergencies are for whatever reason more energizing than the busy days when there’s no emergency even though an emergency always means more work.
We had a real true, in by ambulance, up to the OR in under an hour stat-stat-stat surgery patient the other day. Fortunately we weren’t even busy at the time but my head was completely spinning by the end. I left really feeling proud that things are starting to come together for me. We got a call the patient was coming, and I knew what needed to be done, and was able to start a virtually blind IV on the first try and get the labs when the ER doc was milimeters away from a femoral stick to get them. The surgeon came down and saw the patient and managed to round up a portable ultrasound all on his own and the patient was up in the OR before our ultrasound department managed to send their portable ultrasound over.
We got the call from an urgent care clinic that they were sending us a patient with severe right lower abdominal pain that had vaginal spotting for a couple weeks and was seen in their office and had a heart rat of 170 (should be 60-100)… The patient didn’t know she was pregnant but had a positive pregnancy test in the office. So we were kind of assuming that she was probably a ruptured ectopic, but that was the sum of our knowledge. She rolled through the door on the stretcher and was white as a sheet, complaining of belly pain, and her belly looked a little large to me. She wasn’t my patient, the charge nurse was taking her but I came in to help. First I did the hemaque, I was expecting a hemaque of 5 or less based on her color but it was 8 (normal = 11-14)… I did get the distinct impression it was dropping by the minute.
This was not an impressively organized day because the charge nurse that was in charge is one who gets frazzled easily in general, but it was also her first day as charge. We did get it all done, and the patient was gone to the OR in under an hour. The gyne resident came down later to tell us that they suctioned a full 2 liters of blood out of her belly in the OR.
It was really empowering to go home from work and know that this patient was steps away from going down the tubes, knowing what needed to be done, being able to do it, and getting it done. Horray 🙂