Wednesday, March 12, 2008
i mentioned a possible series. i thought i better at least try. so lets talk about another tube incident.
i was in my icu rotation. our icu was 23icu. but there were about another 4 icu units in the hospital and we had a number of patients spread out throughout the hospital.
late one night i got the call.
"hello, it's sister x in 54icu. could you please come and tube mr y?" i had no patient at that time in 54icu. 54icu was the internal medicine icu.
"who's patient is mr y?" i asked.
"he is internal medicine's patient." she replied.
"well then call the physician on call for icu." i suggested.
"he is here and he asked me to call you." it was time for my standard question.
"should i run or can i walk?" 54icu was about 500m from 23icu and it was an uphill route. i hoped for a gentle walk.
"i think you should run!" i set off. en route, i thought about what i would encounter. an internal medicine registrar was asking for backup in an attempt to tube a patient. i got ready mentally to do a tracheostomy.
i charged into 54icu and what a sight i met. the patient was blue, a colour that in my humble opinion, did not suit him. he was lying in a puddle of blood and vomit. there seemed to be a flurry of activity around his bed, but not much was being done. i decided to attempt to tube him once before i turned to my trusted friend, the knife.
the intubation was quick and easy. once i had done it i couldn't help wondering what all the fuss was about. the patient regained his pink colour before i regained my breath. if i thought the guy was capable i might even have asked the physician to intubate me. i thought better of it though.
"thanks a lot!" he said.
"no problem." i replied. i thought of making some witty comment about needing the adrenal rush or that the sprint up to 54icu could only do me good, but i was still too out of breath. all comments i thought of in that moment were more than one syllable.
"can i just quickly ask you something?" he continued.
"no problem." i repeated. (i was tired.)
"when you intubate, is the trachea anterior or posterior of the epiglottis?" i did not let my face betray what i thought of the question. i just gave a factual answer. he at least had the guts to ask. at least i knew why he had struggled.
resus with hands tied behind my back.