Nov. 29th, 2014

c1: (Star of Life)
In the ER last night for a last-minute four hour shift.

Missed an IV last night in a patient who had tough veins. The nurse gave it two tries (the department maximum before calling someone else) so it fell to the paramedic; a guy I work with regularly. He broke a light sweat, but got the stick in the end. Given the tough time, I don't feel bad for missing my attempt. Indeed, all my recent misses have preceded a nurse missing her attempt, so at least anecdotal evidence that I'm not missing the easy sticks. All the same, missing a stick means an unnecessary hole was made, pain inflicted, and that's not a good feeling. Some discussion with the medic followed; he reminded me that getting good is a process, and it'll just take time and practice. (Scary is that he advocates learning with the lights out, so you can go by feel. He's a bit mad, but in a good way.) 

Later in the evening, got the patient of a lifetime: gigantic pipes running just below the skin. I wouldn't have minded a more challenging patient, but it did make me feel better to get one for the night just the same. And the two kiddos in tow were sweet; one intently playing with some colouring sheets and crayons, both well behaved.

Did a couple more challenging IV medication pushes; mainly challenging for the number, necessity for flushes in between, and sending them in over a defined period of time (about a minute). Worked with a nurse just a few years out of school, so she was great as far as knowing basically exactly what I need from my rotations at this point.

Also got in an assessment of a charming baby who's chief complaint was "crying excessively", and indeed, he presented as mainly inconsolable for a short bit, but for reasons unknown, quieted down while we were examining him. Lung/airway assessment was made easy by his cries -- you don't do that in the absence of good lungs moving good air through a good airway, and he was doing so like a champ. At least on that score, the kiddo was the model of health. It's an exception, where I'm more relaxed *because* the patient is making a lot of noise. A silent baby (NB: unless sleeping) is a scary baby.

November 2014

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