why the f#$@ do you have that cap in your throat?

Survived the first round of nights, I was pretty lucky no one died on my watch. You must be humble as the reason no one dies is rarely related to you. A really busy night last night. There were three "Rapid Responses", the emergency level right below a "medical code" (what you see on television). Regardless with only four doctors managing the hospital you must run for these as well. The first was a "GI bleeder" she was bleeding from her mouth and rectum. She looked like death but medically speaking she was boring, not much to do since she is DNR (do not resuscitate ) and is not a surgical candidate so I called the daughter and told her her mom may die tonight.

The next two rapid responses were for an alcoholic recently arrived from the ICU (my co-interns patient) who was having difficulty breathing. I actually didn't hear the overhead the first time it was called as the overhead system isn't very good and I was either in the ED or elsewhere. They gave him nebulizers hoping he gets better. The next overhead for the same guy I came running. This guy looked like he was having a tough time I reckoned. We check the vitals Blood pressure OK but for some reason he kept getting worse so we prepared the patient for "bagging" and imminent intubation( putting a tube in his throat and hooking him up on a ventilator). As this was going on his oxygen start dropping precipitously, we are about to start bagging (helping him breath by blowing air in with a large balloon) him when the respiratory therapist goes, "first take out that thing in his mouth" ..........what did she say ?......Thing in his mouth ? Holy Shit I quickly yell to the nurses to get a spoon as my friend and co-intern turns him on his side and starts wacking him on his back. Fortunately the nurses bring me instead of a spoon a pair of tweezers. Not having done any practice in surgery or stitching in some time I was a little concerned with my hand-eye coordination, one wrong push and this is down his throat and he is dead. My first try was unsuccessful but on the next try I succeeded. The pt may now be brain dead but alive.


One other quote from a guy with a skin infection last night . "When was the last time you used drugs"?
"A few days ago I put cocaine on the infection to kill the pain, pretty dumb huh"? I told him "Well I don't know I have not heard of that before ". In theory though maybe it does work, not so dumb after all.