Saturday, November 20, 2010
NaBloPoMo Day 20
That's what I did mostly last night. I observed.
I had two patients come in... one young, one old. Both had potentially life-threatening conditions. The young one had croup. The old one had angioedema.
Croup can go bad real quick. One minute you have a reasonably healthy 18 month old, and the next thing you know you're putting in a breathing tube and doing everything you can to help them keep breathing.
Angioedema can go even worse. The tissues in the face swell up in reaction to an allergen. Most often a medication called Captopril, but sometimes it's due to a simple food allergy. The lips swell, the cheeks swell, and then Heaven forbid, the tongue swells. You can do everything right, and the patient may still die. The best case scenario can be a cricothyroidotomy which is basically cutting a hole in your neck to place a breathing tube into. This is the blog post from my first ED Cric.
Unfortunately, the patient later died in the MICU. But, in a strange twist of fate, their child was awaiting a kidney transplant, and the patient was a match. Maybe some things are just meant to happen... although, that experience has continued to affect the way I practice medicine. So, like last night, I gave my medications, and sat back and observed. However, a little prayer now and then doesn't hurt.