Wednesday, July 25, 2007

Anecdotal Cardiopulmonary Holy S**t-ness

Just recently, I had the dubious pleasure of taking care of a late 40-ish woman who had an O2 sat of 36% with a corresponding pulse of 140 on both the sat monitor and the cardiac monitor, and perfect capillary refill. 15 liters of O2 via NRB brought her up to 90% within a couple of minutes. She walked in. Only complaint besides SOB was a little weakness. Go figure. She ended up on Bi-Pap, with a dx of pneumonia. 36%. I shit you not. No diaphoresis, color was good, no confusion, just a little tachypneic (34-36). Of course, she was running a temp of 102. Her blood was HOT when I put it in the tubes for labs. Kinda neat.

Also just recently, I helped out with a 28 year old chick with a 3rd degree heart block. Let me tell you, I was a bit surprised when I hooked up what we all thought was going to be a bullshit chest pain chick to the EKG and saw complete AV dissociation. That bought her a trip to the Big Cardiac Center in the City. Sheesh. She'll go through a couple of pacemakers before she dies- the batteries only have a lifespan of about 10 years, right?

9 comments:

X-Ray Geek said...

Holy crap on the 36%! By chance would she be a smoker?

Kim said...

Damn! And I thought the patient who walks in in V-Tach was a surprise!

Imagine the compensation she was doing to function with that saturation! I'm short of breath just thinking about it!

Loving Annie said...

Good Wednesday morning Monkeygirl,

36 % ????? yikes.

Heraing about the 28 year old maes me incredibly grateful to be healthy, and swearing to never take it for granted again.

Awesome Mom said...

The battery life depends on a number of things. The surgeon that did my son's heart surgeries is working on clinical trials with a pacemaker that never needs a new battery, instead the body recharges it somehow (the conversation got over my head pretty quickly). He was hopeful that by the time my son needs a new pacemaker that it could be ready.

mielikki said...

Sometimes, the human body just amazes me. . .
I love those kinds of patients

Nurse K said...

Um. 36% is incompatible with life? Kinda like very low or very high readings on glucometers, I think I read somewhere that sat monitors aren't very accurate under 70%.

It was probably LOW, but likely not that low.

Anonymous said...

You are so totally smoking crack! Sad part is I can really hear your voice when I read this.

Lola

Ambulance Driver said...

So you're telling me Sidney and Virginia were totally splitsville, huh?

Who was depolarizing her - Jeremy Junction the hunky pool boy or poor old tired Pete Purkinje?

MonkeyGirl said...

It was the pool boy. She had the most beautiful junctional escape that I've ever seen. Narrow, pretty QRS's and everything. To bad you can't count on the pool boy for the long haul. He was doing a great job as a short time squeeze, though.