That’s your heart! Awesome!

Wednesday was a work day. I got paid mostly to read Harry Potter and JEMS, sweet! We only ran three calls, and one of those was BLS anyway, requiring more muscles than brain cells. The other two calls were pretty good. I felt slightly less retarded running them today as opposed to my last shift.

Yesterday I ran with a critical care transport team. My first call was a guy who had a lung transplant last month, and it wasn’t going well. We took him from his bed in ICU to get a lung biopsy. That was pretty cool. First and foremost, I got to wear a lead apron; that was pretty hardcore (and heavy!)
Then they used a bronchoscope to go down his ET tube and into his lungs, where we could see the sutures from his lung transplant. After taking some pictures and performing lavage (which consisted of them injecting saline into his lungs and sucking it back out) they stuck a smaller tube in that went deeper than the scope. This tube had a little claw-type thing on it that open up and grabbed some lung tissue. I could see it on the x-ray as it opened and closed deep inside the bronchioles. Later, I looked at what they had retrieved, and it was miniscule! Amazing how they can make use of such little tissue. Like many medical procedures, I couldn’t help but think about who came up with this first. “Hey, I’ve got a good idea. Why don’t we put this little claw thingy into their lung and just snatch some tissue with it.”

The nurse I was with kindly escorted me into the next room, walked over to the patient, pulled back the sheet, and there was one of the coolest and craziest piece of medical equipment ever. The patient had a ventricular assist device. These are machines that do the job of the left ventricle, using gas to either pull the blood to the ventricle or push it from the ventricle. The device itself could fit in my hand and is (aptly) almost heart shaped. Pictured here. One side of it is connected to the aorta and the other side is inserted directly into the left ventricle. So, it’s kind of hard to explain, but this device was acting as one half of this guys heart. It is outside of the body, and I could see the blood rushing in and out of it, as if I were watching an actual heart. So awesome! Ironically, we had a lecture on these devices on Thursday, so I was uber excited to see one in action.
Again, who thought of this?! “Hey, I’ve got a good idea. Why don’t we put tubes directly into the heart, take the blood out, put it in a plastic heart and push it back out into the body?” Brilliant!
I would guess that the patient has this as a temporary fix until a heart transplant becomes available. This particular model can go for 3 months, but some do exist to be internally implanted and taken home as a complete alternative to transplant. I’m boggled by this amazing technology.

After that we took a patient to have an MRI. This was my first trip to an MRI room. I had to take off all of my metals, and credit cards. None of our equipment could go into the room, which meant extra long IV and vent tubing. The IV tube was about 12 feet long and lead out the door to the pump. The room itself is reminiscent of Wonka’s TV room; large, white, sterile, with huge complicated equipment in it. I watched as the brain MRI was done, and unfortunately the patient had a very large tumor.

In the end I discovered that I can eliminate critical care transport from my list of things to do. I don’t really like dealing with critically ill patients all day. Not because they’re uninteresting or challenging, but because I think the situations the patients were in bothered me somehow. For example: While we were cleaning up after returning our first patient safely to his room, I noticed his wife there, diligently donning her isolation gown and gloves to visit him. She clearly had a routine. I couldn’t help but think about her life. Her life and that of the many others who, via a traumatic event or decay of time are in the same position. Putting on a brave face every single day to show their love and dedication to a terminally ill loved one because that is the only thing they know to do. I admire them, doing the familiar, hoping for a change.