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Archive for March, 2011

This time the story is a little (only a little) complicated and I am currently fighting my rage induced hypertension over it with a nice cup of tea at a local coffee shop. The story may get posted if it actually still seems entertaining in the morning’s light.

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There was another cardiac arrest I worked on recently that was (more) unexpected. A neuro patient (weakness, muscle atrophy, etc) had an MRI late in the day and was kept overnight for observations mostly because he was still too sedated to go home during normal hours. Anesthesia went off without a problem, but he’s had some respiratory infections or pneumonia in the past so we were checking him every hour or so just to make sure he was doing okay and not having any issues.

At midnight he started having some respiratory noise and a little cough, but his lungs sounded okay, so it was likely just some tracheal irritation. At six he was pretty much the same as he had been all night, lethargic but rousable and able to move/walk/interact and mentally there. At seven a colleague ran into ICU and let us know he was either already dead or on his way.

There was running, there was gurney-ing, there was emergency giving of drugs and shocking. There were lots of chest compressions. During a round of these I realized that my recent trainer was correct, compressing along to the beat of a song definitely helps keep the speed and depth of compressions appropriate. Now, the two songs offered to me were “Another One Bites the Dust” and “Staying Alive.” Which you choose, I was told, was based on how cynical you are.

I really wanted to go with “Another One Bites the Dust” because as we know, the survival rates for non-anesthetic arrests are crap, and it amused me quite a bit. That and I really hate the Michael Jackson song. Wouldn’t you know that the one I didn’t want decided to nest its little irritating self into my head. I was grimacing even as I was in the midst of the CPCR because I HATE that song but it would not go away. Alas, I suppose that’s how it goes when it comes to my brain’s emergency defaults.

I wonder which song the King of Pop’s doctor preferred?

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I am in the midst of my small animal emergency overnights. Basically, I spend 12 hours a day, from 8pm to 8am taking care of ICU patients, hospital patients with treatments and whatever emergencies might come in for a week straight. I also field phone calls from worried owners who are trying to decide if it is worth the $160 to come in and have their pet checked out. You might think that someone worried enough to be calling at 4am probably has a valid concern, but you’d be surprised. Most people that call at odd hours do in fact have a valid concern, but some people… well, some people are still just crayzee to steal some of my favorite human med blog term.

Word to human med folks: PLEASE DO NOT give your animals tylenol/acetominophen. Great for humans and human babies, deadly to cats, and pretty darn bad for dogs too. And yes, if you are a human medical provider who brings your pet into us after you’ve poisoned them through your ignorance of species differences, we will judge you. In the back room, amongst ourselves, after doing our best to save your pet, of course.

We spent some time Sunday night (Monday morning, really) rounding on CPCR and the new guidelines on the human front, which were in part based on animal and specifically dog studies, so they’re useful for us too. What to do in what situation, best drugs, which things are useless, that kinda thing. Wouldn’t you know we get an older dog come in last night for a history of GI symptoms that just wasn’t looking so good? She went from not looking so hot, to us putting in an IV cath to v-tach within about 5 minutes.

Lidocaine didn’t do squat, procainamide kinda made the ECG look a little different for about 0.2 seconds and then she went into fibrillation. She was a DNR, so we just kinda stood and watched her go for a bit. But then the actual real doc in charge decided to go ask please if we could shock her, and about a million years later we got permission to shock her once. It didn’t do anything, unfortunately but not unexpectedly.

On the plus side, necropsy showed a giant tumor, so she probably had a good reason for deciding to die on us and cement in my head the CPCR review I had just read. Teaching cases are valuable, even if her poor parents were completely shocked and devastated. No one expects to take their dog in for inappentance, vomiting, and lethargy and have her drop dead just like that. Especially if they’d been in somewhere else earlier and told that she probably just has an upset stomach.

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News to Me

One news article that horrifies me below, especially knowing how hard some women try to avoid miscarriage and still wind up losing the pregnancy. I will disclose that I am pro-choice, but I am also Very Very pro-birth control. I would much prefer a world where no one became or caused pregnancy without intending to.

Miscarriage illegal on pain of death in GA

This one makes me feel a little better about america. A little, at least. The insane bigots spreading hatred and pain in the name of their god still sadden me however. I am ambivalent about the supreme court decision because I do think it was the right one, but it pains me that it benefits those particular individuals so obviously.

Veteran Christian Bikers guard family and funeral of fallen soldiers from Crazy Lunatics

ETA: This made me grin because it’s so very true. People ask for advice they don’t want all the time and then reject it out of hand.

I want to lose weight without eating less or exercising more

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In Search of a Home

Anyone know of a 2-3 bedroom, 1.5-2 bath, 1000-2000sqft house with a nice sized fully fenced (or fence-able) yard for sale in Corpus Christi? A decent kitchen and lighting is a plus.

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