Wednesday, 24 February 2010

CRASH CALL!!

Alright well due to extreme busyness from both essay deadlines and intercalated personal statements this blog is seriously delayed - I even started writing some of it 2 weeks ago and never finished and posted :S. So sorry about that!

On friday (two weeks ago!) had the most awesome ward round ever! Literally! Reading the title of this blog you might think I'm a bit weird for saying that but I'll tell you now (spoiler alert..) that the patient was ok at the end so I think I can say legititmately say that it was awesome. So heres what happened...



I was on a ward round on CCU (cardiac care unit) with one other student and a lot of doctors (3/4 registrars, and 3 F1/F2's and we were going around seeing patients in turn who had recently had acute coronary events - such as angina, MI's or had just had arrthymias detected. After seeing several patients we reached one elderly gentleman whose heart was absolutely racing at over 200 beats per a minute and his monitors were bleeping away to alert the staff to this problem. In all honesty though the patient didn't seem that unwell considering his heart was pumping so fast and he was replying quite coherantly to the doctors. Then the nurse got him to sit forward because his blood pressure wire had gone underneath him so was not recording properly and the doctors needed to know seeing as his heart was going so abnormally fast. Then all of a sudden the patient collapsed and before I knew it the doctors and nurse were rushing around performing CPR, closing the curtain to all the other patients beds and grabbing the crash trolley. The patient had gone into ventricular fibrillation - one of the shockable types of cardiac arrest.



And it was just like ER/House/ Greys/ whatever medical drama you choose to watch. It really was, everyone scoffs and says it isn't really like how it is portrayed on tv but in this case from my position of hiding out of the way with my back pressed firmly against the curtain of the patient opposite it really was. The only difference really was that in England they don't use defib paddles but sticky pads that you stick on the patient (apparently it decreases the number of times staff accidently shock themselves). The nurse said at one point that she felt the patients ribs crack and the doctor in charge dramatically yelled out everyone stand clear before he adminstered the shock. And then in this case (just like in ER) our patient magically recovered and regained consiousness - I hear this is not often the case, but then again I suppose you are going to have a cardiac arrest you couldn't really pick a better time than when 7/8 doctors, 2 nurses (+ two useless observing med students!) are standing round your bed.

The patient then got rushed off to theatre to have a temporary pacing wire put in so that this way he could have medication to control his fast rhythms without causing more slow rhythms than he was already suffering from as the pace wire would stop these. Problem solved and life saved!


After this ward round I didn't really have much more on medicine than the odd bit of teaching and my CBD exam. My cbd exam went....well pretty awful to be honest. I got an ok mark but the experience in general was horrific as I got throughly grilled - normally consultants wait to the end of your case presentation and then ask just a few questions but the consultant doing mine prefered asking throughout and asked hundreds of question. Eeek! It really made me lose my flow and I know I was beetroot coloured by the end but at least he wasn't a harsh marker as it happened and I somehow still got an ok mark. I guess thats the main thing!

Had my halfway there ball (as we are halfway through our medical degree) last week, was awesome!! Now I actually am half a doctor allegedly :).I am now on surgery but will save that for next post so that I actually post something now rather than delaying further!!
So, will try and post sooner next time!

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