Monday, December 17, 2007
Free at Last
I survived my ICU month. Yesterday I stumbled out of the hospital after my last call night EVER. I know that it was a good rotation education-wise, the hours were just so tiring. Last week I spent 85 hours in the hospital, with much of them being without an attending being in house.
My last call night was rough. Most of the day we spent trying to fix this guy that needed surgery. His pH was 6.9 and his potassium was over 7. All day long we poured blood and various medications into this guy, and even dialyzed him, hoping to get him stable enough for surgery. In the end, the surgeon signed off, saying it was just too risky.
Meanwhile, one of my usually more stable patients responded to being ignored all day by going into SVT. I pushed adenosine (medication that temporarily stops the heart) and when that didn't work but slowed him down long enough for us to see that he was in a-flutter, we started him on several other medications. While all of this stuff was going on, we put central lines into two other patients, performed a lumbar puncture, and admitted another patient who was having a heart attack.
So it was a busy four weeks. While there wasn't much time for reading, I did learn a lot on the job. I also suppose my confidence level went up a bit. I am halfway through my residency program now, with the remaining time being pretty much all in the emergency department. There are just a few more rotations left, but none will have the intensity of high-acuity patients or the time demands of the intensive care unit.
In the last 24 hours it has snowed over 12 inches here, and rather than the usual melt away mess, it really has built up. This morning I wasted by lounging away, but it took me 1.5 hours to clear the driveway and we're supposed to get more tonight.