You really shouldn't deliver dead people to the ER. There's not a whole heck of a lot we can do for them. Above all, you should not deliver dead people to the ER when a brand new attending and a brand new nurse are on duty. This is not a good combination.
Billy Bob's family pulled up into the ER bay - well, came screaching in sideways with smoke coming from their brakes would be a more accurate description. Billy Bob's brother jumped out of the truck. "OH MY GOD MY BROTHER IS DEAD!" he screams as he runs into the waiting area. "He's dead, he's dead, he's dead! HELP HIM!" he yells at Dr. S, grabbing him by the front of his scrubs.
"Ummmm............. OK", Dr. S replies. (This is where you can see me rolling my eyes and heading off to lunch. I'm a cold hearted bitch sometimes)
You know how stories grow as they get passed on to new people? They grow and develop a completely different storyline than what actually happened? I'm not so sure that's not what happened here. This story took on a life of it's own (no pun intended of course).
So Newbie Nurse runs out to the ambulance bay with Dr. S. Dr. S proceeds to open the back door of the Mercedes and comes face to face with Stone Cold Stiffy. Stiff as a board (coincidentally, not light as a feather), sitting upright in the back seat. Hands curled under his cheek as if he's daydreaming.
Dr. S touches him. No response. "Uh, Dr. S, I think he's dead," Newbie says. (ya think? He's stiff.)
Dr. S checks his carotid and says in a surprised voice "He doesn't have a pulse." (figured that one out all by yourself, did ya?)
Dr. S makes his first big mistake - "Bring him on in to the trauma bay" he says.
"Seriously?" Newbie replies.
"Yes, seriously. Bring him in."
"Shouldn't we just call the police or the funeral home or......?"
"Absolutely not" Dr. S replies. "We'll bring him in and hook him up."
"H....h....hook....h...him....up-p?" Newbie stutters. "But he's dead"
"He's not dead until I say he's dead" Dr. S replies
OK, now do we believe this? Not sure - but it makes for a great story. Dr. S is a bit of .......... well, that's better left unsaid. Newbie, bless her heart, obeys him. She's sweet and unsullied - naive to the ways of ER nurses. "Um...OK" she says. Um..........OK my ass. My reply would have been somewhere along the lines of the following:
"You wanna bring the dead guy in Dr S, feel free. I'm not wasting anyones time hooking up some obviously cold, stiff, and dead guy to the cardiac monitor to prove he's dead. He's dead. He aint' moving (insert poke to guys head here). Call the cops or the funeral director. Hell, call the national guard. I don't care. I'm going back in to take care of the guy who's on the verge of crumping in room 3. When you feel the need to grace the ER that is full of sick patients with your presence, just let me know. But I'm not BRINGING IN THE DEAD GUY!"
"Um, OK" sounds so much nicer, doesn't it?
Anyway, they bring Mr. Stiffie into the trauma bay, proceed to hook him up (by the way, he's in complete rigor so he is still in a sitting position) and discover that he is in (everyone gasp here) asystole. Duhn duhn duhn.
Quick! Shock him! (SNORT - this isn't Lifetime Movie Network people. Here at ERTV we don't shock asystole - we give 'em a thump on the chest and they'll magically convert to sinus rhythm!)
Dr. S heads out to have a family conference and Newbie covers Mr. Stiffie with a sheet and calls the morgue. Charts are started, dictation is completed. Resources are wasted.
Did this really happen?
The only truth I know is I saw a sheet shaped an awfully lot like someone with their knees in the air being wheeled to the morgue as I returned from lunch. You learn not to ask questions.
Wednesday, December 27, 2006
Saturday, December 16, 2006
Thursday, December 07, 2006
The (un)Reality of TV
Forgive me, for I have sinned. I watch medical dramas. Yes, I do. I watch them and I giggle, then I snort, then I guffaw, then I shout at the TV "THAT'S NOT HOW YOU DO IT YOU IDIOT!". Meanwhile my husband rolls his eyes and walks out of the room. We have a cool relationship like that. He rolls his eyes and leaves whenever I yell at the TV. We've bonded.
Let's do a low down on this fall's TV shows (medical drama or not)
1. One Tree Hill
Do the powers that be seriously think that we will believe CPR compressions are performed on the abdomen? And did you know we're supposed to check a carotid pulse after every 3 compressions? Wow - these must be the new 2005 guidelines everyone is up in arms about. What is even more amazing is that Lucas (yeah - that's the character's name. Not George Lucas, he probably would have gotten it right) was supposedly "not breathing" yet a simple oxygen mask stimulated his respirations and created enough of a BiPap pressure to keep him alive. Wow! The studies that we could do on this.
Don't even get me started on Hailey. Seriously - hit by a car, thrown into the air, pregnant, and unresponsive. Cut to the doctor telling her husband that she has several fractures in her leg and she won't wake up. Oh - and he can't worry about the baby right now, he has to save the mother's life (yeah, OK so I agree there - don't tell anyone). Cut to the next scene where Hailey is in a hospital bed with no oxygen, IV, or monitors in place. She also has a cast on her right lower leg with it suspended in a sling - but no traction pulleys are in place on the bed. It's a miracle! She also wakes up with a clear voice, not the scratchy one we usually hear from someone who hasn't spoken in ages. Hmmmm.............. Oh, and of course all is well with the baby.
2. Grey's Anatomy
Residents who purposefully endanger the lives of a patient so they can get to the top of an organ donor list are not graciously allowed back into their programs because they "meant well". Residents that are pissy whiney babies don't go far in medical school without a serious "come to Jesus" meeting. Oh - and IV tubing that ends nowhere doesn't help the patient much. Just a few thoughts there people. Give me time. Give me time.
3. ER
If there is an IV bottle hanging beside the patient, make sure 1) the bottle is dripping, and 2) the patient has an IV site. Easy peasy? Please, for the love of all that is holy, please correctly identify heart rhythms. Afib is not the same as a 2nd degree block. It's really not. Finally, not every ER nurse has an affair with an attending. Some, but not all.
4. Soap Operas (all of them)
People on ventilators need an ET tube coming out of their mouth, and noone uses those black accordion "shwish shwish" ventilators. Not even rural hospitals.
5. Any other show on television or major motion picture
Everybody all together now: "You do not shock asystole, You do not shock asystole". Good job class.
Gold stars all around!
Let's do a low down on this fall's TV shows (medical drama or not)
1. One Tree Hill
Do the powers that be seriously think that we will believe CPR compressions are performed on the abdomen? And did you know we're supposed to check a carotid pulse after every 3 compressions? Wow - these must be the new 2005 guidelines everyone is up in arms about. What is even more amazing is that Lucas (yeah - that's the character's name. Not George Lucas, he probably would have gotten it right) was supposedly "not breathing" yet a simple oxygen mask stimulated his respirations and created enough of a BiPap pressure to keep him alive. Wow! The studies that we could do on this.
Don't even get me started on Hailey. Seriously - hit by a car, thrown into the air, pregnant, and unresponsive. Cut to the doctor telling her husband that she has several fractures in her leg and she won't wake up. Oh - and he can't worry about the baby right now, he has to save the mother's life (yeah, OK so I agree there - don't tell anyone). Cut to the next scene where Hailey is in a hospital bed with no oxygen, IV, or monitors in place. She also has a cast on her right lower leg with it suspended in a sling - but no traction pulleys are in place on the bed. It's a miracle! She also wakes up with a clear voice, not the scratchy one we usually hear from someone who hasn't spoken in ages. Hmmmm.............. Oh, and of course all is well with the baby.
2. Grey's Anatomy
Residents who purposefully endanger the lives of a patient so they can get to the top of an organ donor list are not graciously allowed back into their programs because they "meant well". Residents that are pissy whiney babies don't go far in medical school without a serious "come to Jesus" meeting. Oh - and IV tubing that ends nowhere doesn't help the patient much. Just a few thoughts there people. Give me time. Give me time.
3. ER
If there is an IV bottle hanging beside the patient, make sure 1) the bottle is dripping, and 2) the patient has an IV site. Easy peasy? Please, for the love of all that is holy, please correctly identify heart rhythms. Afib is not the same as a 2nd degree block. It's really not. Finally, not every ER nurse has an affair with an attending. Some, but not all.
4. Soap Operas (all of them)
People on ventilators need an ET tube coming out of their mouth, and noone uses those black accordion "shwish shwish" ventilators. Not even rural hospitals.
5. Any other show on television or major motion picture
Everybody all together now: "You do not shock asystole, You do not shock asystole". Good job class.
Gold stars all around!
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