Sobtanian's old blog. Still full of goodies, why don't you stay a while.

Saturday, March 19, 2005

"Needs to be Blue-Lighted to London Chest"

Picture this: Friday morning, around 10:30am. I'm doing a ward round with the ever-faithful house officer. One of the new patients on the ward (codename FM) had had a heart attack the morning before. She'd been given the magic clot-buster drugs and was doing well. After saying hello to her and making sure she's ok, she mentions that she's got a bit of shoulder pain, radiating up to her neck. *SHIT* I ask for an ECG (heart tracing), and the nurse gives me one she'd done at around 9:30am, but just clipped it on the routine jobs thingie. Looking at the ECG, it's evident that FM is in the process of having ANOTHER heart attack as we speak!
Giving her a bit of morphine, I ask for another ECG. guess what? the attack is extending more and more into what's left of her heart muscle! *SHIT*
I gather all her papers and tracings and trot down to the cardiology (read: heart specialist) registrar, who happened to be conveniently on-call that day. She had one look at them and said "needs to be Blue-Lighted to London Chest. I'll come up". She came up and wrote up some fancy heart-doctor-only drugs, and spoke to her equivalent at The London Chest Hospital.
Soon after she had left, FM's blood pressure decided to dip down to 70mmhg systolic (anything less than 100mmhg is scary) *SHIT* calming her (and myself!) down, I tilted her bed head down and gave her some fluids in the vein. This helped up her blood pressure to 90mmhg. ACCEPTABLE.
The ambulance crew finally arrived, and me, a nurse, and 2 technicians took FM down to the vehicle. With use we had a plethora of pumps/monitors/adaptors/drugs and all that. They wheeled FM into the ambulance and then me and the nurse hopped in to sit sideways throughout the 50 mile journey. Soon after departing, our driver did what we were all looking forward to, he turned on The Blue Light. With lights flashing and sirens whistling, everyone got out of our way and we got there in record time. It was a rattly experience with everything jumping up and down, but an exciting one nontheless!
FM was a bit unwell in the last bit of the journey, she had more chest tightness and needed more pain relief (not surprising, her heart was half-dead already!). We got to London chest and took her up to CCU, where bed 5 was ready. The registrar there wasn't a pleasant one, I think that being faced with a sick person with half a dead heart at 4:30pm would make anyone grumpy.
We bought some ice creams (it was warm!) there and drove back home (no blue light, I pretended to have chest pain in the ambulance but they wouldn't buy it!). We reached Colchester at around 6:30pm, long after work had finished.
It had been an exciting day. Blue-lighting someone to London Chest was more fun than I thought, if it wasn't for the fact that there was a very ill patient with me, and a nurse that was sick throughout the journey!

Oh, and PLEASE don't smoke. PLEASE. This woman smoked 15/day, and she's just one of alot of people I see who end up like that. Don't say you weren't warned. Not everywhere has blue-lights to london chest.....

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