Apprehension built up from classes ahead of us had convinced us that pharmacology would be the next great test of our abilities to incorporate and ultimately retain a massive amount of material. The previous student were correct, there was a large amount of material to retain, but the mountain was not quite as tall as they had made it sound. I walked away with an "A" without feeling very tested. Do I remember every detail of every drug, no. But I walk away with a huge interest, which will compel me dig deeper in an attempt to know more than the average medic. Really, do any of us actually say "I just want to sneak by, hoping to avoid the ton of trouble created by not properly caring for our patients. No we want to be the smartest kid in the room of smart kids. We are too damn proud to just be "in" the room of smart kids. Which is of course the bane of every medics existence. We believe deeply that knowledge is power. Our pharmacology section is completed, the road work has been laid. From here on out it's our job to finish on our own.
We start our airway section on Monday. We've been given a large reading assignment to complete over the weekend. Adding a little flavor as we sizzle in our new frying pan.
Saturday, April 12, 2008
Saturday, April 5, 2008
Redemption
During our pharmacology we've of course been practicing our IV techniques. For some this includes blindly digging with hopes of just a little blood to show a flash, while others must be using the magnetic needles that seek out veins. I've been somewhere in between, constantly tortured be the wing needle. We start testing on Monday.
Dispatch to a late 20's or early 30's male in seizure. After ascending the stairway to heaven we find our patient. Presenting in the usual manner, prone on the bathroom floor and of course with his pants at his ankles. You almost made it buddy. His tachy and fairly hypoxic at 74%. He continues to wiggle around, his usual postictal activity as we are told. With a big bear hug and some quick work on the pants we chair lift him down the stairs to our cot waiting at the front door. He continues to tug on the oxygen mask and flail about as we head for the ambulance. I'm tasked with starting an IV on Mr. Seizure. Honestly I would have rathered him still be in seizure as I think he would probably not have such large movements. Lethargic as his is, his still remembers what an IV is and how it feels. I find a perfectly suitable vein, much more accommodating than anything I've found in class. The 18g slides right in, and is if on cue he moves and I lose my tamponade and the blood drains down onto my leg and on the seat as I move his arm over it. With a little clean up, it's as good as gold.
Why can I start a perfect IV in a moving rig, on a fighting seizure patient with rather dark skin, but can't seem to strike gold on an arm placed perfectly on a table, beautiful lighting and skin like porcelain. The outcome is ultimately better for the patient, but not for my grades.
Dispatch to a late 20's or early 30's male in seizure. After ascending the stairway to heaven we find our patient. Presenting in the usual manner, prone on the bathroom floor and of course with his pants at his ankles. You almost made it buddy. His tachy and fairly hypoxic at 74%. He continues to wiggle around, his usual postictal activity as we are told. With a big bear hug and some quick work on the pants we chair lift him down the stairs to our cot waiting at the front door. He continues to tug on the oxygen mask and flail about as we head for the ambulance. I'm tasked with starting an IV on Mr. Seizure. Honestly I would have rathered him still be in seizure as I think he would probably not have such large movements. Lethargic as his is, his still remembers what an IV is and how it feels. I find a perfectly suitable vein, much more accommodating than anything I've found in class. The 18g slides right in, and is if on cue he moves and I lose my tamponade and the blood drains down onto my leg and on the seat as I move his arm over it. With a little clean up, it's as good as gold.
Why can I start a perfect IV in a moving rig, on a fighting seizure patient with rather dark skin, but can't seem to strike gold on an arm placed perfectly on a table, beautiful lighting and skin like porcelain. The outcome is ultimately better for the patient, but not for my grades.
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