So our 1st post of the new year will serve a reminder to me most of all rather as education for others. Its about not spilling blood.
A patient with COPD and IHD presented with SOB and a wheeze to the department and bronchodilators were started with a normal looking CXR.
He was looking much better but suddenly went into a malignant broad complex rhythm and was promptly defibrillated. ROSC was achieved in a few minutes and a decision was made to intubate him for hypoxia as well as post arrest airway protection.
A RSI checklist was commenced and I was asked by a competent nurse whether a 2nd IV line was needed. For a brief few seconds I thought about forgoing that step and to quickly proceed with what looked like a difficult intubation and the myriad of complicated following steps...
Somehow and from somewhere, cooler thoughts prevailed and I got an available med student to insert one under guidance.
In compliance with Sod's Law; prior to intubation, blood was seen to be leaking from the trolley and pooling on the floor from the site of the accidentally avulsed 1st IV line.
Disaster mitigated, undoubtedly, by nurse and papyrus safety net!
Last line of this masterpiece by "The Boss" goes - God have mercy on the man who doubts what he's sure of.
Our checklists can be found here.
The debate (funny one) rages on here.
Extreme checklist mania here.
Have a fruitful 2015.
A patient with COPD and IHD presented with SOB and a wheeze to the department and bronchodilators were started with a normal looking CXR.
He was looking much better but suddenly went into a malignant broad complex rhythm and was promptly defibrillated. ROSC was achieved in a few minutes and a decision was made to intubate him for hypoxia as well as post arrest airway protection.
A RSI checklist was commenced and I was asked by a competent nurse whether a 2nd IV line was needed. For a brief few seconds I thought about forgoing that step and to quickly proceed with what looked like a difficult intubation and the myriad of complicated following steps...
Somehow and from somewhere, cooler thoughts prevailed and I got an available med student to insert one under guidance.
In compliance with Sod's Law; prior to intubation, blood was seen to be leaking from the trolley and pooling on the floor from the site of the accidentally avulsed 1st IV line.
Disaster mitigated, undoubtedly, by nurse and papyrus safety net!
Last line of this masterpiece by "The Boss" goes - God have mercy on the man who doubts what he's sure of.
Our checklists can be found here.
The debate (funny one) rages on here.
Extreme checklist mania here.
Have a fruitful 2015.
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