night 4... much busier...

ovarian cancer lady desaturated bigtime around 0230, left side whiteout on cxr* compared to earlier in the day (only lower zone shadowing at that time). attempted chest tube for suspected collection (had bilateral effusions with her condition couple weeks ago, treated with bilateral drains) or even haemothorax, cuz the change had been rapid... nothing. just clot and lung adherent to chest wall, hardly any pleural space at all. so closed without drain. at which point she became periarrest. =(

intubated her and bronchoscoped her... turns out she had LOADS of gunk in her left main causing the collapse. picked up a bit after suction and washout.

boy, kept me busy for a while...

simultaneously, got called by the cardiothoracic ward for another lady getting into respiratory trouble. this lady originally presented with dysphagia and extrinsic compression of her oesophagus from a mediastinal (tracheal/carinal) mass, biopsied to be poorly differentiated scc* from either oesophagus or lung. i brought her down to the unit for cpap*, responded well, her trachea just being splinted enough to buy her some time until her carboplatin chemo due later today.

kept me busy too...

didnt have time to check out world events unfortunately. =(

food of the night:

jumbo hot dog with the works

----
* cxr = chest xray, scc = squamous cell carcinoma, cpap = continuous positive airways pressure

posted by Chas at 08:35
go ahead, roll the donut!