Tuesday, 4 December 2007

The Adrenaline Rush

4th December 2007
21 Days to go till Christmas

tlm fact: All through primary school, I was obsessed with becoming a policeman. So much so that I used to wear my little uniform whenever possible and whenever I wrote my name on my school work, I always wrote: PC Little Medic so I could pretend to be a policeman. Fortunately I did grow out of this and spent many years after that wanting to be a vet. I changed my mind only a year or so before applying to medical school. I've not yet taken to writing Dr Little Medic on my work so I can pretend to be a doctor.

Yesterday, I went to see some endoscopies, expecting a nice relaxing morning. Fortunately for the patients, everyone was normal. That was until there was an addition onto the list, an elderly (70+) lady who'd recently had a GI bleed. She had already been scoped but they couldn't find where the bleeding had been coming from. Her haemoglobin was already ridiculously low (i'd never heard of a Hb so low). They scoped her again and found where the bleeding must have come from and made an attempt to stop any future bleeding. Unfortunately, right there in front of our eyes (well, on camera), an artery started spurting blood inside her stomach. From this point, my heart started pounding in what must have been an adrenaline rush. By now the endoscopist couldn't see a thing because there was blood everywhere so he couldn't do anything about it. He called down the best endoscopist in the hospital to see if he could do anything and he also called the surgeon on call to take the patient to theatre if nothing could be done. Before I knew it, the room was crammed with people. Endoscopists trying to stop the bleeding, the surgeon on call and an anaesthetist assessing him for theatre. Various other doctors were running around like crazy putting cannulas in and taking blood for cross matching. Blood and fluids were being put up by the bucket load. Meanwhile I was in the middle trying to hold the patient down as she fought to remove the endoscope despite being sedated.

They couldn't do anything endoscopically, so they took her down to theatre to open her up and try to stop the bleeding. Unfortunately thats where I had to leave, so I don't know what happened. I guess I'll find out today. I hope she is ok.

I feel bad that I was sort-of excited by the emergency response to her rapid deterioration. I suppose it must have been the rush of adrenaline as people were running around me trying to do their best for the patient. The whole team were fantastically calm despite what I thought was quite a serious situation. I think it was dealt with really well and maybe the adrenaline rush that each member of the team must get helps them to do what they need to do efficiently.


Anonymous said...

Woah, pretty dramatic day LM. It does sound exciting though. Fingers crossed for her though it does sound bleak.

Misha said...

Do fill us in when you get back! It beats an SSC in the horrors of GP-Land!


AMiB said...

"I feel bad that I was sort-of excited by the emergency response to her rapid deterioration."

I know EXACTLY what you mean! It's especially bad on slow days in the ER. You really want the major trauma page to go out, but you know that means someone has to go through something horrible.

I figure it'll get better over time? hopefully lol

ditzydoctor said...

OH CRIKEY I"M SORRY!!! i couldn't get the button to work and pressed tag 3 times. cripes. am so sorry!

and it sounds mighty exciting = but anything in medicine that is exciting is probably bad for the patient. :( it's a matter of striking some balance i guess. cheer up tlm!

Pro et Contra Medic said...

”Meanwhile I was in the middle trying to hold the patient down as she fought to remove the endoscope despite being sedated.”

Quite naturally to be excited in an emergencie, especially went it might have come as a surprise (?). But you did something, and that is not what all would have done in your situation.

I hope for the best regarding the patient

PhD scientist said...

Did she have a Venflon put in for venous access before she was scoped, LM?

Just curious.

the little medic said...

phd scientist - yes she did, infact she had two in but one of them was buggered. She was on 1 unit of blood at the start of the procedure.