Sounds like he did let it go and not let it get to him.
Even I try to check back up on what happened to critical patients later on. That doesn't mean I can't cope. That means I'm curious.
Rubber meets the road tomorrow
- Thread starter rhan101277
- Start date
Sounds like he did let it go and not let it get to him.
Even I try to check back up on what happened to critical patients later on. That doesn't mean I can't cope. That means I'm curious.
In the acute phase it helps to recognize the wave forms.
It is helpful to know the PaCO2 to know the gradient with the ETCO2. V/Q mismatching and deadspace can be an issue depending on the different pathologies especially in the acute.
We sometimes have an issue with "well meaning" CCT teams that think, by just looking at the ETCO2, that the sending hospital is "over ventilating" the patient because the ETCO2 is low. We will occassionally receive pts from them with pHs of 6.9 and PaCO2 of 9O as the CCT team will try to "normalize" the ETCO2.
OP
OP
rhan101277
Forum Deputy Chief
- 1,224
- 2
- 36
I do let it go, I just wonder how people did. I guess if I get them to hospital alive I did my job. I finished up my ER rotation, I saw someone have a seizure. I was the only one in the room, I had to keep the guy from falling off the bed or hurting himself and quickly get the RN and doctor while his wife was hysterical. I didn't freak out or get hosed, but I definitely felt my adrenaline kick in and when I see people get emotional its tough. I don't show anything on the outside, on the inside it saddens me to see it. I guess thats life though. Also had a guy come in with chest pain he had nitro sublingual x2, his respirations were very high 35-40 and shallow. He would keep insisting to go to the bathroom they finally let him and he got back and got worse. I watched them as they had to ET him because his breathing was so in-effective. He aspirated some blood to and they suctioned it. Later I learned he had a non-stemi MI, which means he didn't have the "classic" ST elevation signature which correlates to a totally blocked coronary artery. He had a partial blocking mid right coronary artery, I helped them get him to the cath lab, he survived. His BP got all the way up to 180/110 and while they were ET tubing him is O2 sat went down to 80. I had several other pt's where I watched vitals and assisted where I could, listen to breath sounds and heart sounds.
I also saw a dead person, I don't know if I already noted this. I didn't get hosed but I was nervous somewhat. Haven't seen any massive trauma yet, so have to see how that goes.
I don't feel overwhelmed, but does it just take time not to be bothered by other people's emotions and the terrible situations people see themselves in. I mean I can't help but feel for them for what they must be going through. Also seeing the fear in people's eye's when they know something is wrong. This little old lady almost starting crying, I put my hand on her shoulder and said, "you know you are in good hands and you are at one of the best hospitals" I don't know if those words gave her some comfort or not. She had trouble breathing, shallow and fast respirations, no diabetes. The EKG showed no issue, they have her some medicine to clear her lungs out though I didn't hear any rhonchi sounds. But I am about as beginner as it gets. They also set her up with a ECG as well. I did hear rhonchi sounds which sounded like snoring from a woman who attempted suicide, BP was 60/40 with low MAP. I went to see where he was getting the dopamine drip from and they also put here on lactated ringers for her electrolytes, she had been on normal saline and was having to urinate alot due to the dopamine. As far as I know she survived, don't know if her liver will.
Anyhow sorry to write a book, done with rides and clinicals though and I didn't runaway scared. I enjoyed helping people and comforting them, monitoring vitals, setting up O2 etc.
I also saw a dead person, I don't know if I already noted this. I didn't get hosed but I was nervous somewhat. Haven't seen any massive trauma yet, so have to see how that goes.
I don't feel overwhelmed, but does it just take time not to be bothered by other people's emotions and the terrible situations people see themselves in. I mean I can't help but feel for them for what they must be going through. Also seeing the fear in people's eye's when they know something is wrong. This little old lady almost starting crying, I put my hand on her shoulder and said, "you know you are in good hands and you are at one of the best hospitals" I don't know if those words gave her some comfort or not. She had trouble breathing, shallow and fast respirations, no diabetes. The EKG showed no issue, they have her some medicine to clear her lungs out though I didn't hear any rhonchi sounds. But I am about as beginner as it gets. They also set her up with a ECG as well. I did hear rhonchi sounds which sounded like snoring from a woman who attempted suicide, BP was 60/40 with low MAP. I went to see where he was getting the dopamine drip from and they also put here on lactated ringers for her electrolytes, she had been on normal saline and was having to urinate alot due to the dopamine. As far as I know she survived, don't know if her liver will.
Anyhow sorry to write a book, done with rides and clinicals though and I didn't runaway scared. I enjoyed helping people and comforting them, monitoring vitals, setting up O2 etc.
Last edited by a moderator:
OP
OP
rhan101277
Forum Deputy Chief
- 1,224
- 2
- 36
Well the rubber meets the road again tomorrow, when I will be at the ambulance station from 8a-3p. This time I am bringing books to study and do homework. Watching movies is fun but I want to be productive. Last time I was there for 14 hours and only got 4 calls. Which I think only two will count, maybe even just 1 of them. Anyhow now that the initial call butterflies are done, I am hoping to be able to do more, depending on who I ride with. Wish me luck.