Monday, August 13, 2012

I Can't Breathe!

It never fails.  When you are going to have a bad case it always seems to arrive the first hour of your shift or the very end of it.  This one showed up about and hour before quitting time.  Unresponsive.  Vital signs are great and he snoring.  So I am cutting clothes off, while triage nurse gets info, someone is starting a line and getting blood and then I alert the ER doc.  Who isn't happy that we waited this long.  That would be the triage nurses fault since he is also the charge nurse.  But what do I know.  Anyway.  The doc gets history from family which doesn't help.  No one seems to know what this guys  new depression med is or if it's a narcotic.  So the doctor orders Narcan to reverse possible over dose.  He has had 2 rounds of it no luck.  Doctor orders Remazicon just in case it's a benzo over dose.  I on the other hand would like to shove a catheter in this guy so we can get a temperature and output.  Before the ER doctor wakes him up and I can't get a Urine to find out what the hell he has taken.  Nope off to CT scan where the dude wakes up screaming.  I can't breathe!  I can't breathe!  All the while thrashing around on the CT table.  Needless to say  he was breathing just fine.  Now the unresponsive is acting like a full blown bath salts patient.  Fantastic.  No Urine now...and no CT.  Back to the ER to sedate the patient because he is still thrashing and yelling at the top of his lungs.  Apparently the Remazicon worked.  So lets put more drugs on board.  Makes plenty of sense to me. Now the doctor is thinking about intubating the patient.  Wouldn't that have been easier in the beginning?  She then mentions remind me to intubate first ask questions later...Welcome to the night shift rodeo.

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