Fasting? Try Money
Last night shift was pretty sweet. I slept in relatively uninterrupted comfort from about 0145 to 0630. We started the evening with a local student who, after playing a game of organized sports, collapsed on the sidelines. We arrived and he was pretty out there but responded to pain and us shouting his name. The coach informed us that the student is currently celebrating Ramadan, and hadn't eaten since about 5 o'clock that morning. It was about 6pm when we found him. So, we start a line and took a sugar, and it was only 44. Well, that's not normal, especially if you haven't eaten in 12 hours. So we gave him some glucose and thiamine and he perked right up. I love calls where it feels like we're actually helping people. It was my first experience with a call as a result of a religious holiday, and I was pretty fascinated. I learned a lot from the patient, that is, once he was conscious.
That was pretty much the highlight of the shift as far as I remember. I was pretty excited to get a fair amount of sleep, as I had planned to go kayaking right after work. I changed clothes (added layers) and got on the water around 0730. It was early enough that a fog was rising off of the cool water, making for a very eerie kayak trip. It was about 33 degrees when I started, but I stayed pretty warm. Most of the fog had burned off by the sun as I finished a couple hours later.
Most of my weekend was typical although we were a bit busier for some reason. The most interesting call was for a kid who had swallowed a coin, roughly the size of a quarter. This would have been fine, except that the coin was too big, and got stuck part of the way down. The ER here tried direct laryngoscopy (pretty much looking down his throat) and decided the coin was too far down. Since it was a three and a half year old, they didn't have a bronchoscope small enough to retrieve the coin, so we took him to a more specialized hospital. The kid was doing fine otherwise. No trouble breathing, vitals were good, I was pretty much not concerned that anything stupid would happen en route. I talked to the doc briefly who basically told me that if the patient developed any problems, that I could knock him out with some valium use my laryngoscope to look, if I saw the coin "Pull the sucker out!" and if not, just "shove a tube in there." I found this pretty amusing, especially if I had to do it. The kid did fine on the way there, and I'm sure that the offending coin was removed shortly after we dropped him off without complication.
That was pretty much the highlight of the shift as far as I remember. I was pretty excited to get a fair amount of sleep, as I had planned to go kayaking right after work. I changed clothes (added layers) and got on the water around 0730. It was early enough that a fog was rising off of the cool water, making for a very eerie kayak trip. It was about 33 degrees when I started, but I stayed pretty warm. Most of the fog had burned off by the sun as I finished a couple hours later.
Most of my weekend was typical although we were a bit busier for some reason. The most interesting call was for a kid who had swallowed a coin, roughly the size of a quarter. This would have been fine, except that the coin was too big, and got stuck part of the way down. The ER here tried direct laryngoscopy (pretty much looking down his throat) and decided the coin was too far down. Since it was a three and a half year old, they didn't have a bronchoscope small enough to retrieve the coin, so we took him to a more specialized hospital. The kid was doing fine otherwise. No trouble breathing, vitals were good, I was pretty much not concerned that anything stupid would happen en route. I talked to the doc briefly who basically told me that if the patient developed any problems, that I could knock him out with some valium use my laryngoscope to look, if I saw the coin "Pull the sucker out!" and if not, just "shove a tube in there." I found this pretty amusing, especially if I had to do it. The kid did fine on the way there, and I'm sure that the offending coin was removed shortly after we dropped him off without complication.
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