I've worked in the ER long enough to feel confident in what I do. I can do that 12 lead ECG with my eyes closed, I can get the IV first time and draw blood without bruising my poor unsuspecting patient. I *can* do it. I do do it... and most of all, I enjoy it. Well, at least until the end of last week. I think the universe decided I was getting too big for my boots and knocked me clean out of them.
Without going in to enormous amounts of detail, towards the end of my shift, we had a 30 something year old lady come to us with chest pain. She had a significant family history (both parents died of MIs before 40) and her ECG showed huge ST elevation. Oh and before I forget - she was 38 weeks pregnant... and she coded.
So, skipping over the gory bits (for my sanity as well as yours), there was a very quick and dirty c-section in the ER, not an OR with dad watching. Mom didn't make it but the baby is going to leave the NICU tomorrow morning.
I didn't know that pregnancy increases the risk of the patient aspirating and that I needed to apply cricoid pressure. I didn't know that my hand position for chest compressions should be moved up the sternum or that the uterus needed to be displaced. I didn't know, I didn't know, I didn't know...
I've learned a lot from it and in that respect, I'm grateful for the experience. I just wish I hadn't been left feeling like I've failed... but I guess thats the price you pay for for all the great stuff being in medicine gives you the chance to take part in.
2 years ago