Wednesday, March 12, 2008

tube


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 fun.
cuban resus.
resus with hands tied behind my back.

5 comments:

rlbates said...

So do these situations happen often enough to keep you in shape or do you run in your off time?

Bongi said...

there seems to be very little need to run in my off time. most people i meet while not at work don't seem to need me to tube them, so i don't really run around tubing people except at work.

Unknown said...

The worst one I had was when I was rushing to the bedside and found the intern reading through the patient notes... Gee that makes sense, cardiac arrest, read notes first to get background history.

rlbates said...

Did I say run to tube? I wanted to know how you stayed in shape, other than just running to codes. :)

Anonymous said...

Great story Bongi.
It would have helped people like me if you had written the correct answer to the question ;o)