Monday, June 30, 2008
Thursday, June 26, 2008
At this point, the patient's father came in the room and said that central lines wouldn't work on his son (which doesn't make sense) and that he would have to have a PICC line (large catheter placed into one of the arm veins). So, we abandoned the procedure, and called for the PICC team.
And that's when the patient decompensated. He went from a heart rate of 120 to 160 to 200. The monitors get very angry when one's heart rate is 200... that's a whole lot of beeping! I had already had a sinking feeling about my failed procedure, but this just confirmed it. A quick portable x-ray showed it all: the patient now had a pneumothorax.
There was no time to wait for a PICC line. This guy needed fluids, antibiotics and was heading towards needing a pressor. Quickly, I put in a femoral line while the ICU was called. The ICU resident automatically called the cardiothoracic surgeon and that's how I ended up creating business for my least-favorite surgeon. The treatment for a pneumothorax is to put in a chest tube to decompress the air and reinflate the dropped lung. I'm capable of doing a chest tube on my own, but by that point surgery was involved and it was too late to uninvolve them.
Wednesday, June 18, 2008
Thursday, June 12, 2008
Day 2 was another full day of walking, museums, and monuments.
Recently built (2004) World War II Memorial:
The Washington Monument:
The Lincoln Memorial:
Korean War Memorial:
Statue next to Vietnam Memorial:
Statue honoring medics/nurses during wartime:
The Jefferson Memorial:
An inscription inside read:
I am not an advocate for frequent changes in laws and constitutions, but laws and institutions must go hand in hand with the progress of the human mind, as that becomes more developed, more enlightened. As new discoveries are made, new truths discovered, and manners and opinions change with the change of circumstances, institutions must advance also to keep pace with the times. We might as well require a man to wear still the coat which fitted him when a boy as civilized society to remain under the regimen of their barbarous ancestors.
We also squeezed in the Smithsonian Air and Space Museum, and attempted the Holocaust Museum, but they were closing up for the day. There are so many things to see and do there, that I would like to go back again sometime. It was fun having a weekend with AG to explore and ignore phone calls and email.
Tuesday, June 10, 2008
I am still not sure what they meant by "Kiss & Ride" at the Metro Station:
No clue what building this is:
J. Edgar Hoover FBI Building:
The White House:
This was at the Smithsonian Museum of Natural History. The title of the display was something along the lines of "Man Taming a Goat". It cracked me up, because if I worked in a museum, I'm sure I would get bored with setting up traditional displays.
Changing of the guard at the Tomb of the Unknown Soldier:
That night, we had tickets to a murder mystery dinner. There were some strangely dressed people in the audience that we had originally thought were part of the cast, but it turned out that they were just bizarre people in the audience.
Sunday, June 08, 2008
We found these while walking around town:
This one was at Arlington National Cemetary:
Behind the Lincoln Memorial: