ok, so almost coming to the end of night 2 on the unit...

one less patient tonight. autoimmune pneumonitis lady suffered another episode of massive haemoptysis during the day before i came on. when you bleed into your lungs like this, there is just no way of oxygenating the body. basically, you drown in your own blood. there really is not much one can do when that happens. she died. rip.

had to reintubate another lady, getting better at rsi* by the day. having been potentially ready to be stepped down to the cardiothoracic surgery ward earlier in the day, our boss made a good call to delay stepdown until her respiratory status was more stable. she has copd* on top of having just come out of a double bypass. very good call. shortly after i came on tonight, i put in a chest tube to relieve her right pleural effusion, hoping that would help her oxygenate better... got 200ml out... but still low po2... i think shell do ok.

the lady next to her is not doing so good. emergency salvage redo of a lima* anastomosis to her lad*, maxed out on full inotropic support, iabp* at full inflation going at 1:1, lvef* at around 20%... doesnt look like shes going to be around when i return tomorrow night i fear.

managed to eat during this shift, pretty good going. =)

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* rsi = rapid sequence induction, copd = chronic obstructive pulmonary disease, lima = left internal mammary artery, lad = left anterior descending artery, iabp = intraaortic balloon pump, lvef = left ventricle ejection fraction

posted by Chas at 07:27
go ahead, roll the donut!