To work used. It seems that everything that happens during the day, worthy only of mention in the morning on the shift change and the house for Breakfast. Ordinary, routine, not positive. But there are times that stuck in my head. Perhaps they are not worthy of a separate post, but maybe this will interest someone. So. The change was not particularly active. Of the 6 patients in the minds of only one, and the one with lung cancer in the terminal stage. By evening, my sister and I shared a dream, I went first. In 3 hours she wakes me up, and I’m going to listen to what interesting and new happened while I was gone. Next, the nurse Vale(not Vale) – I – Ya In – all is quiet, the journals filled, purpose you only 6 this morning, everything seems clean. Linen is not much left, so you see who to replace. Here’s the patch, latest. Here’s the tube for analysis, syringes were prepared. Look for the fourth, the pressure began to fall. The second half an hour ago began to choke him, I hormones introduced, now asleep. The syringe next to him, if not help, Wake the doctor. I – well, thank you. Kettle on the bedside table? – Oh, I see. Only we discussed it, the second was again to choke. Exactly what I’m talking about the man with oecologia. Very nice polite man, 50 years old. We approach him, seated, increasing the oxygen flowing through the mask, check the sensors. Saturation – 87% Saturation – blood oxygen saturation. In a healthy person figure 100-99%, in our patients up to 90% more bearable, if less – you need to do something. Pressure increases, heart rate also. The patient is scared, pale, shortness of breath with labored breath. Val introduces more drugs. I run in procedure for syringes and vials for next time. Next, observe the patient. The success variable. Saturation then 92, 85. Takes 5-7 minutes, no result. The patient conscious, trying to say something. The more he worries, the worse his condition. Confused says to me “well, looks like I’m dying.” Don’t like it when patients say that because they have nothing to answer. People with respiratory failure have a strong fear of death. We often bring patients with PE (pulmonary embolism), such patients are at a greater risk. Can die at any moment for reasons beyond our control. Also breathe and feel “death”. Can not lie, and hard to reassure. We are trying to calm the man, simultaneously collecting all the necessary for intubation. He’s already all wet, the sensors, the bandages fly off like oil from his skin sweating. Of acrocyanosis (posinenie on fingers and ears) no, but I’m going to Wake the doctor. Experienced doctor comes in, stares at the patient 2 minutes. Feel like in his head of thoughts that do not want to intubate because there is a sense that the problem is not so serious, and the patient in mind. Command dial 20ml of Propofol (a hypnotic drug that causes medication sleep) and enter the jet 10ml. Input. The man literally falls asleep on the needle. And lo! Saturation – 98%, no shortness of breath. Val goes to sleep. After 20 minutes, the patient wakes up and immediately starts to choke. Again enter the hypnotic sleep. The doctor says to dilute 20ml of propofol 250 fizy and slowly drip. In this mode we lived. As soon as he wakes up – it dropped faster, falling asleep at normal speed. While he slept, I did my job, we have perestrelo nurse, washed the sick and sleeping, too. So it took no less than 3-4 hours. Pressure slowly returned to normal as the healing solution was to end. During this time, the appearance of the patient became more or less normal, pallor gone, the sweat is also, of respiratory failure. My thoughts on his account began to calm down, I’m glad that after such a terrible night for him, he was able to sleep well and relax. And what was my surprise when I accidentally woke him up closer to 8 am, and he tells me “everything, nothing helps, I can’t”. That is, for him, all those hours of sleep was not noticed, if they had never existed. It is the same tired and scared. He explained the situation, offered to sleep. An hour later, my shift ended, I don’t know that have to come up with a different doctor. The cause of his condition was heart failure and high pulmonary pressure, which interfere with normal breathing. Pressure decreased symptoms went away. Morality is not. Be well.
Today with my son sat on reception at the doctor (In) in the children’s Department of the city TB dispensary. Have fun looking “only to ask” mother (M): M – I forgot to ask – will you be than to treat our monthly cough? In – That will come on Friday with your child to […]
Plus again about communication along with patients. Recently I look a grandmother to the question of her varicose veins of the lower extremities. Well, grandma older, but is quite safe, varices in her presence, the time to study so I sit, she lies, talk talk. And what on the couch I talk all about disease, […]
love to read posts about the work of doctors. The ones where people’s lives are directly dependent on the professionalism of others. Very respect people who love their work,save lives,despite all the ingratitude on the part saved . My mother was a doctor,35 years in medicine. Talked a lot about work. Yes, and I spent […]
Want to tell the story about how I dreamed since childhood of becoming a doctor and did not work. When I was little my grandmother has been an EMT, and my mother worked at the hospital. Grandma was constantly telling stories about working on the ambulance and I was interested to hear. All my childhood […]
a typical day in the children’s medical center. I ENT. In the hour of reception of acute patients comes into the office mother and daughter, the girl whines, it hurts. Behind them, paying the door, on the verge of rebellious man: — I do not understand how you then take? Why I am sitting in […]
Dear doctors and subscribers of the group! I have boiling, want to vent their resentment. I myself am a medical student, and let that I’m a doctor with lots of experience behind you, but now I am ashamed of our medicine, namely for the relationship between medicine and religion. It all started with my first […]