Yes, another week of nights has rolled around, and so you get incessant whining from the Kate creature. Less so, perhaps than normal because I may, potentially, have actually saved a life.
Not solely of course, as part of a team, but for the first time ever (yes, seriously, there’s always been a doctor ready) I hit *charge* and *shock* on a Defibrillator as part of an arrest rhythm. Not only that, but the reason the individual was in the cath-lab and having an arrest just-prior to having her heart’s vessels (hopefully) reopened, was because when he’d rocked up from triage in my bay I’d gone *I’m bloody sure she’s having an MI*.
I’ve not seen an MI for a while, they usually go straight to the cath lab, but this one presented a little oddly (some mild back pain) and her first ECG was ‘unremarkable’. So much so that if it hadn’t been for the vague ‘epigastric’ pain that accompanied the back pain the ECG would have been a one off. That and the fact she looked like shit.
She then said the pain was worse, so another ECG was done, this time even I could spot that it was (a) different, and (b) had some ST-Elevation. ST Elevation is your ‘you are having an MI’ marker, essentially. And so in went a nice big cannula, while the doctors rang the cath-lab which, inconveniently is not right next to the ED. A swift run down the corridor, and I have to *love* the staff nurse who grabbed the defib pads with the defib/transfer monitor, and said ‘hey, shall I come with you’. She would, incidentally, have had those bits of kit on the trolley with her, but he also, when we got there, and I noticed a VF arrest – managing to say something like “Shit, that’s an unfortunate rhythm” while simultaneously trying to shift cognitive gears from a really, really quiet shift to ‘CPR NOW!’ had the good sense to remember where he’d put them, open the pack and was there with me in slapping them on her chest. Me, I was slicing the gown off while one of the docs was doing CPR.
Still, when I left the Cath lab she had a heartbeat and was conscious again, and they were just prepping her for the actual cardiac catheterisation.
So, yay for us. And for once I get to big-up me for checking the monitor* :)
* Normally I’m whining inside my head about what I didn’t do. I have to say, for once, despite not quite being as on-the-ILS protocol as I’d’ve liked, I actually did everything I should have.
