c1: (Star of Life)
[personal profile] c1
Yesterday, I got two more sticks. Being the day before T-day, the ER was understandably quiet: frustrating, because there's that checklist thing. But I did get two small things.

One was when the cardiac patient came in, and the nurse told me "we need an IV fast, so you need to tell me if you're going to get it, or if you need me to do it." Moments later, I watched my fingers practically shoot the cannula* into the vein on the first shot. Somehow, everything came together, although there was a point when I remember telling myself to push the cannula forward faster than I'd been doing, but about as fast as I'd been watching the nurses do it. Boom, there goes the dynamite.

Two was the number of intra-muscular and subcutaneous injections I gave; rare, but they have a place. Easy, because you're just playing darts with the patient as the dart board. But there are a few things to practice there.

Did a couple patient assessments, but was unsatisfied with them. Reflected on that at work later in the evening, and came up with a better way, that I'll be trying tomorrow night. It's another example of where the words in the book part ways with reality. (The damn advice from the book to start IVs at a 45 degree angle being one of the more acute annoyances on that front.) A doctor laughed at me a little when I asked about ascultating lung sounds from the chest instead of just the back; apparently this should have been obvious, yet the book stresses the back is the best place. Hmmm... book says one thing, doctor standing in front of me says another. *Shakes head* 

Saw a patient I'd treated last week, and was happy to hear the kind words she had about my care. Nice when that happens.

Got to see the classic allergic reaction to penicillin. It's one thing to see a patient covered in spots in the textbook, but seeing it in person was pretty wild. No acute distress, though she was itching like mad -- we gave her stuff to calm that down, and she now knows not to get *cillin meds until she's seen a specialist about the reaction.

Made a few beds, did a few other chores, endeared myself to the ER staff a little more. It's the little things, from me as well as from them.

*IV needles come in two parts: the needle, and a plastic cannula that covers it over. The whole thing goes into the vein, but once you're just in the vein, you pull out the needle and advance the cannula further. It's the cannula that stays in the patient, through which the fluids and medications flow into the body. The needle itself is spring loaded, so when you're in the vein, you push a button, which retracts the needle into a "safer" plastic sheath so you don't poke yourself inadvertently. (This was a major cause of unprotected patient care provider exposures, hence the spring loaded needles.) 

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