Before Finals A late post
Before The last Final..
Hey guys! How’s it going? I have been MIA on this blog for a while because finals is killing me. Yesterday was clinicals and I have to say I experienced what happens in the ER. After 7 weeks of clinicals something finally happens. Not that its good for the patient but stuff happens.
So I went to my clinicals we were just about to do the oxygen rounds for the first time before we leave for the last day. It was fine and I know most RTs don’t like doing oxygen rounds because its time consuming when you have the rounds along with your assignments. To me oxygen rounds was something I looked forward to. 20mins we were just talking and listening to the stories about the “trauma” night where they had the longest Code ever. We were just about to do the rounds when we hear a page overhead. “RT Staff to ER” (something like that) So one of the RTs called the ER to see what was going on. Seems that we get a patient who could NOT breath at all. I’m assuming the patient had little ventilation with a little bit of respiration. We grab a ventilator and a tray ( I still don’t know what was on the tray). The RT made me grab a manual resisitutator (AMBU BAG)
At that moment we rushed to the ER and while I’m holding the AMBU BAG a lot went thought my head. Since I’m only a student, I have NEVER bagged a patient yet. What if I do something wrong?, What if I forget everything I learned? What if I blank out? And of course the question went to my mind of… “How the hell do I use this?” I had training of the bag but since different manufactors make different ways I never tried using it. This one had Oxygen tubing coming out and I didn’t know where the bore tubing goes. On the walk I studied how it worked and I finally got it. I started to think positive. The patient’s life is NOT exactly in my hands and if worst comes to worst we have 5+ staff (doctors, nurses..etc..etc..) next to me.
We got to the ER and the patient could Not breath. The patient was intubated (I wish I saw this) and one of the RTs were already bagging. They connected the ventilator to the patient and for a few mins I was watching. So many people were just walking in and out. So then the RT said..we can not use the Ventilator. I guess there was blockage or something. ( remember I’m a student and I don’t know how vents work yet) So they took him off the vent but this time they called ME and said.. “come here and bag”. WOW I was bagging a patient who could not breath and I have 1 semester experience. So they put medication and after a few mins they were able to use the ventilator. The patient was “stabilized”
I got to listen to breath sounds 3times. I can’t describe what I heard since I don’t have the vocabulary / terms yet. The first time there was not much things to hear (bagging). Next one was a loud noise like there was restiction. The last one was a weezing which I guess meant he was stabilized.
I was able to see how a patient would “stack” oxygen. (if that is the right term), From what I over heard, when the patient was taking in the air into the lungs, he was NOT expiring enough.
Whew that was a crazy CODE. We finally got to do our rounds. I added a few on the list because some of them had oxygen that was not on the list of oxygen patients. I didn’t realize how much patients moved around. At least 3x I had a patient who was not in the room. Either D/C or out in the lab.
Sadly this was my last day of clinicals. We stayed for an extra 15mins to say our goodbyes and thank yous to the RTs that assisted us for the last 7 weeks. I was sad when we were walking out. Right before we were going to walk out we heard this
“Alpha Trauma Code Heli”
We stopped and all smiled. The RT said “you guys don’t want to leave right now right?” We all stayed and so excited to see this. A patient was transported by a helicopter. We got to see how the worst comes to the hospital. I saw exactly what I saw earlier that day and this time I looked at who was who. I saw that the physicans were the “boss” of the whole thing. Because they are the ones with the best knowledge. The RNs were doing the best they can to help the physicians. I also saw that someone was always charting. I don’t know what the position is to get that job. Very important to listen because so many things to chart and there is no room for someone saying “what was that? Speak louder”. They also had the lab techs goin in to take CXR (chest x ray). The other lab techs were drawing blood. Then the housekeeping people cleaned up anything that was lying around. The EMTs were filling the information of what happened. And of course I can’t forget to mention the RT. The RT is the one who was managing airway. I know I forgot a lot more but that is all the staff I can recognize.
Pretty interesting day. 7 weeks of doing regular things like , IS (incentive spirometry), O2 rounds, SVN (small volume nebulizer) treatments and it all caught up with 2 traumas.
As for right now, I’m going to hit the books again.