Last post expressed my amazement at medicine. Thursday was an epitome of a medical miracle! My patient had a "ruptured AAA," meaning her aorta (the main vessel from the heart running down the abdomen) ripped open. She was taken to immediate surgery, where she lost 5.5 liters of blood (the human body only has about 6). The surgeon opened her up, patched the aorta together, gave a bunch of blood and sent her to us. The next 4 hours we frantically dumped in 31(!) liters of fluid, gave all kinds of medication, ran tests, etc. 2 or 3 times my blood ran cold we almost lost her. But the intensivist kept giving orders and she made it through her first few hours...
The night shift ran all through the night, doing the same. When I came back the next morning, she was basically stable--maintaining blood pressure (with medications' support), looking (almost) pink, perfusing to the point of palpable pulses, and making pee (the things we get excited about as nurses! But that means her kidneys were getting blood). That lasted the whole day. She is not out of the woods, but doing fantastic considering her condition.
I was reading a study (USC center for Vascular Care) that says almost half of patients with ruptured AAAs die before reaching the hospital. Of those who make it to surgery, between 50-70% die. Not surprising, since they open the biggest vessel in their body! So, she is quite a miracle and I'm totally amazed at medicine, again!
**Here I put in a plug for my co-workers. There were 3 other nurses on the unit, each with 2 sick patients of their own. Yet all 3 rushed into my room when the patient arrived to help me get things going. 2 PCTs ran tirelessly: getting supplies, running labs, and making calls. Even my manager popped in (shirt, tie and all) to see if he could help. One nurse stayed with me until the end of shift, hanging blood, checking lines, etc. Another stayed not only until the end of the shift, running tests and helping the doctor insert lines, but he also stayed 2.5 hours(!) after our shift to help me check orders and chart. We finally finished with that patient and he was ready to leave. But, he learned I still had to chart on my other patient and that I was parked 1/2 mile away. He insisted on staying until I finished to ensure I reached my car safely. Wow! I feel spoiled!**