Hey guys. I'm Siobhan, a first year medical resident.
This is part 2 of a 24-hour call shift in the intensive care unit.
So if you haven't checked out part 1, take a look first. As a recap, I'm on call with my friend Carol.
She's a
second year internal medicine resident in the same program as me. We saw all the patients in the ICU in the morning and then we
got called to the emergency department about an unstable patient.
Her breathing was so bad and her blood pressure was quite low, so we had to go with her to the CT scanner in case
she got a lot worse while she was lying down.
Wow okay, so we're really hungry.
My gosh.
This is actually ridiculous. It's almost 10:00. It's almost 10:00, yeah.
And we haven't eaten since 12:00.
And just to be clear, the cafeteria closes at 10:00 and then there is like no food. So Carol was just saying... It's just a bad situation.
I was saying I was gonna pry the cafeteria doors open if it was closed right now. Yeah, seriously. Anyway,
we will update you in a little while, but it's been a crazy afternoon.
I have hungry breath right now.
Yeah, I don't even want to know.
Oh, no!
There's no more left.
Wow, this is truly a
nightmare. Okay, so thank goodness they found us some sandwiches, so we actually are gonna have some food tonight.
So, all is good.
Okay.
Feet are up.
Haha.
Oh my gosh. This is actually out of control.
It hurts to talk.
Honestly, it's just my feet.
My feet are killing me.
My head is killing me.
Hahaha.
Oh, so let's catch you guys up on what happened since what?! Like 4:00 o'clock.
Yeah, when we were going to the CT scan. Good news is that this patient did not have a PE,
but then... She's very sick. Yeah, very very sick. Yeah, mm-hmm. And we ended up getting
we're checking her gases regularly, so actually that sounds pretty bad.
Okay, not her gases, we're talking blood gases.
So they call it an ABG and you're basically... It helps you see how much acid or
bases are in the blood and that tells you how sick a person is or at least tells you a little bit about how sick
they are. And
hers were very bad, so she had way too much acid. Yeah. Ehm, and...
The respiratory therapists who... They do this all the time. Yeah.. This what they do bread and butter every day.
And they said it was the worst
blood gas that they've seen, like ever. And ehm... Needless to say that made us a little bit nervous. Yeah, very nervous.
And then in the middle while we're dealing with that, we get a STAT page from the ICU
that someone needed to get intubated. Yeah so this ICU nurse... So ICU nurses handle a lot, they are like very calm people.
They really know what's going on, they know way more than we do yes. Yeah, they're excellent.
It's when I have an ICU nurse telling me on the phone like I need you down here ASAP,
I think this person needs to be intubated.
I was like ''Oh my gosh!'' So I'm looking at Carol and she's like looking at this blood gas. So I say ''Okay,
I'm gonna head downstairs and get on this patient who needs to get intubated, ehm...'' While I deal with this
horrendous gas.
And then two minutes later, I get another STAT page from the ICU from the room that needs to get intubated. That was from me.
So I come running down and Siobhan is just standing there all gowned up.
I was ready to go, but then I was like ''Oh my gosh,
I can't do this alone, like I need backup.'' So I was like, I told the nurses ''Call Carol STAT, like get her here
right now."
So I come running down
and then...
Yeah, Siobhan handled it like a pro. She intubated all by herself,
she got on her first attempt.
Yeah. It was in a perfect place. Okay, but I had a lot of help. It was perfect.
Yeah, but that was like I've got the whole team around me. You've got two respiratory therapist there, lots of help,
they're like ready to help. And now both patients are actually stable, the gasses are looking better. Yeah, gasses are looking good.
Yeah. Siobhan did two central lines all by herself.
That is true. Okay, I'm feeling like a very proud of that.
They were not easy lines. Yeah, I'm feeling pretty proud. Yeah. Cause those are the first ones I've done by myself.
Anyway, so
needless to say, we are now looking for a little bit of resting.
Yeah, just... Just like debrief, see if there's anything else we need to do. Yeah, I think I forgot to write notes on like all
people. We have to go back and do that. Go back to the notes. Check blood work again. Yeah, okay.
12:30 a.m. Literally right as I was going to my call room,
just got a page and there's a patient who's going to the operating room, but is having some problems with their blood pressure.
It's kind of low, so they want us to see right now.
So anyway, trying to figure out where this room actually is. Alright, so Carol caught up with me.
We've got... We thought we were gonna get a moment of rest. Yeah, put my head down on the pillow
and Siobhan woke me up.
Hahaha, for a good reason.
Turns out this patient has a really low blood pressure. We're gonna have to put in a central line.
Yeah. So that's one of those like IVs in the neck. Yeah.
We're just gonna go get the equipment now from the ICU and bring it over to where the surgeries happen.
The ultrasound, got some equipment.
So
dealt with the consult, walked around the ICU to see if there any other issues. I know there's some blood work
that's gonna be coming back in about two hours.
So I'm hoping to get a nap during that time, so you know... Fingers crossed and let's see.
So no other new patients so far, but I keep getting paged like quite regularly about potassium either
too high or too low. And I feel like each time I nod off to sleep, I get like woken up about potassium. Oh, hahaha...
And the last page that I had, I think cuz I was sleeping I thought the pager was my
alarm, so I was actually hitting my phone, try to snooze it, not understanding
why this noise wouldn't turn off. Until I realized where I was and what was going on.
I needed to phone someone, because I was being paged. Okay, I'm gonna try to get a little bit more sleep.
So it's 8 a.m., just heading to the cafeteria now. Carol and I are gonna meet there
and then I think we're just gonna walk around the ICU and tidy things up.
Make sure, you know, there's nothing that needs to be done before
we get to go home. Do you have like post call guilty pleasures, kind of? Yeah,
usually I'll have like a bad breakfast post call. Like I'll get a greasy breakfast sandwich.
And then like post call, I'll just let myself do anything. I'm like ''Oh, I deserve it.'' Yeah, I think same with me. I don't know, probably
just sleep for a while, maybe go for a movie.
It's gonna be very very chill day. Yeah, I thought I was gonna get more sleep, then I didn't quite get as much.
Alright, so it's now just after 9:30.
We have officially handed over, pager is out of our hands. Gone, no more pager. It's like the best moment, I'm not responsible anymore.
So yeah, like crazy night. But honestly it made it fun, because it felt like I was on with a friend.
Yeah. And it made me feel like we were just kinda hanging out. Yeah.
And
Siobhan did a great job. Did all of the lines by herself, she intubated by herself.
Yeah, it was great. It's a big night of learning, it's exciting. Thanks so much for watching.
Don't forget to subscribe if you want to see more videos like this. And comment below if you have any comments or questions
or you know, things that you'd want to know about the ICU, what it's like to be on call together.
So bye for now and we'll chat with you soon.
You