Sunday, June 26, 2005

What a day so far!!! GEEZ!
The cuss words I'd like to put on my blog, but can't (apparently, my folks read this blog too).
5 admissions and one death so far, the last one we flew in on helicopter, and spent 3 1/2 hours resuscitating and stabilizing her. Bled like stink, and received over 15 units of blood in the last 24 hrs. Have never seen anyone bleed like that before.
It's 530am now, not worth going to bed anymore for that one hour of sleep.
Right now, I'm thankful for 3 things:
  • That I'm not the patient
  • That I'm not going into Critical Care medicine
  • And Endocrinology has no inhouse call
1 more week...
Despite our efforts and the patient's determination to stay alive, she passed away after my shift. Basically bled to death after the family decided to withdraw care. She was suffering from terminal cancer, and was bleeding from an arterial-enteric fistula. Our vascular surgeons felt that surgery would only be temporizing (she had failed a previous procedure).
It was like a warzone today, in that one single ICU room. Alarms going off every few minutes. Nurses and doctors shouting orders to the respiratory and IV techs. Large volume lower GI bleeding with reflux hematemesis. Basically was vomiting blood onto the bed every 30 minutes, despite our continuous NG suctioning. Good thing she was intubated. She received over 30 units of blood products.
Despite a rectal tube connected to suction, her bedsheet was soaked with blood, clots everywhere. Blood on the floor. Blood splatters on my shoes.
I don't think I can come up with a better definition of chaos.
I'd like to imagine that things were more peaceful for her when she passed on. That, after the family decided to withdraw support, she was comfortable and the room kept as quiet as possible. Our nurses are usually very good with things like that.
Wherever she is right now, I pray she's finally at peace. And I hope I'll be able to sleep tonight without having nightmares.


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