Why do people fight in the middle of the night? They should be sleeping or at least sitting quietly watching TV. A radio call from the ambulance alerted us. "35 year old male stabbed in the chest, no pulse. We'll be there in 5 minutes". Luckily the senior doctor has not gone home, so everyone is alerted and standing ready. He is blue lighted straight into our resus room and the dance begins. It is unfortunately all very well rehearsed, we have done this before. Clothing is cut off, IV access is obtained CPR is ongoing monitors are attached fluid is hung up and run through. everything is getting done. Blood warmer which doubles as a pressure bag is already primed and ready. O negative gets started and blood is taken for cross match. The blood transfusion people are called to get more O neg while we are waiting, "Whats the patients name?" they ask, "we don't know" we tell them. "You need a name to get more blood" true but there are systems in place for situations like this. This technician has never heard of them and is not giving his blood out without a name. Only time I have ever heard the senior doctor swear. He grabs the phone and shouts down "Get the fu***ng blood here now." Blood duly arrives. Meanwhile we are fighting a losing battle. This guy is dead unless we do something but we are not giving up yet. Stab wound through the heart, blood everywhere. Get the thoracotomy tray, we are going to open him up. My job in all this has become a combination of photographer and transfusion nurse. I am taking photographs and then putting blood up and repeat - we can put a unit of blood through in 3-4 minutes and every one has to be documented and checked so I am kept busy as is everyone else in the team. The chest is opened, the wound in the ventricle found and sutured all while one doctor is doing cardiac massage but success, we eventually get the heart going - thready and weak - but going. Surgeons appear and take this guy to theatre to close his chest and then to ITU. He has got massive problems ahead of him, was he deprived of oxygen for too long, will he get an infection? Unfortunately, we will never know unless he dies tonight, as once patients disappear into the black hole that is the hospital we never hear of them again. But, he was dead when he reached us and he was alive when he left us. Good job by us and a quick chorus of Queen's "We are the champions".
What caused this stabbing? He was arguing with his brother while they were both drunk.
Tuesday 17 June 2008
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2 comments:
Good job........ we say in the service....... Was he alive when you dropped him off? If the answers yes then you did your job and shouldn't worry about the rest!
Easier said than done, I've had a few patients I've wanted to follow up but not been able to.
Good Job. You did your best and you had his heart beating so at least he was a total DOA.
Speaking of stupid people who drink and then get violent..... Take my oldest son. He has a friend who he "parties" with and this so called friend has now stabed him twice. Does he learn and get new friends? yes and no. Yes becasue he will find new friends but in the mean time he keeps an eye out for this friend and when they run across each other they are back to being "party" friends again.
O and BTW this friend is the same guy whom distroyed our house (where Im at now) but I could not press charges on him as he did not have a written lease(we didnt let him in our son did) He paid our son in cash then our son sent us a check for the payment while they were here for 5 years. But you can bet our son didnt get his deposit back either.
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