Because I just got paged about a patient he's got heart rate about 30 and
They've got ST elevation. So it looks like they're having a heart attack right now
Hey guys, I'm Siobhan, a first-year medical resident. It's now just after 5:00 p.m
I finished a day of oncology clinics, so
cancer clinics of different kinds and
Now, I'm just heading over to start my night on call an internal medicine
So let me you bring you along for the night and see what happens and then next week
I'll tell you more about being on a cancer service
So I just dropped my stuff off in my call room
And I'm heading down to the emergency department to do my first consult of the night
Just done with that first consult and heading back to my call room now
So
um
that first consult was a patient who was incredibly short of breath to the point that
They were waking up actually gasping for air had to be sitting upright. They had lots of swelling in their legs
So this is really a classic case of what we call heart failure. So giving this patient some IV diuretics
So basically a water pill through the IV making them pee off lot of this extra fluid that they're accumulating
Now maybe I should actually grab some food at this point. It's probably gonna get to be a little bit busy later
All right, so it's 8:30 now. I'm just heading to the cafeteria to grab some food before the cafeteria closes
All right, so got myself
some soup and
Actually got a treat for the team
This yummy popcorn chips for later tonight
But of course before I can eat I've got to answer this page
Hi, this is Siobhan, I'm from team D turning a page
Okay, um, what's her blood pressure like?
Okay and her heart right now
Okay, that's pretty fast yeah, has she been like that for a while
What kind of fluids is she running
Okay, so let's give her another 500 milliliter bolus now of the ringers lactate
And then I'm gonna come down and see her to see how she's doing. Yeah
Okay, perfect. Yep. Thanks very much
Oh! Again
Hi, this is Siobhan from Team D returning a page
And, um
what are her sugars normally like?
Mm-hmm
Okay, and what lantus dose is she getting tonight? Oh
Sure. Okay. Yeah, let's decrease it from 15 down to 10 and you just put to reassess that tomorrow as well
Great
Thanks
Okay, finally those pages are done
Now you just have a little bit of soup and I figure I can just catch you guys up a little bit because I was just
on vacation
I had two weeks off, which was amazing. I went to Greece
Santorini for five days makes me wonder why everyone doesn't just live there because it's incredible and then hiked around
Mount Olympus and
then flew off to Norway to one of my best friend's weddings, which was absolutely beautiful and
It was really acclaimed to be one of her bridesmaids and really keep that friendship going
So anyway, it was a fantastic time
So it's just ten o'clock now, so I am gonna take a nap and try to get some rest before my next consult
No, not already!
Alright, heading down to the emergency department for my second consult of the night.
We'll see what it brings
Right, so just done with that second consult and so it was a patient who
has end-stage
Liver disease so basically their liver is failing and coming in with complications of that. So treating them for a lot of edema
Some confusion and bringing him them into hospital for that reason
It was I just got paged about a patient who's got a heartbeat about 30 and
They've got ST elevation. So it looks like they're having a heart attack right now
when I assess the patient, he was complaining of chest pain and
This was as ECG clear signs a heart attack
Because his heart rate was so slow. I called a team to bring in pacer pads to the bedside
These are pads that actually get stuck on to a patient's chest and can deliver electricity
Directly to the heart so that we can control the heart rate
I then called my senior medical resident for backup and we started something called triple therapy
So three different types of blood thinners to treat the heart attack
Then we called a cardiologist and arranged for an ambulance to actually transfer the patient to a different hospital where the cath lab is located
Because the patient was so unstable an ICU nurse and myself went with the patient in the ambulance between the hospitals.
I sat there watching the monitors with epinephrine in my hand ready to act in case his heart actually stopped
Luckily that didn't happen and he arrived safely to the cath lab
The cardiologist then incredibly threaded a wire up into his heart and managed to open up the blockage in the artery
Saving his life
So my work was done and I was able to hop back in a cab and go back to the other hospital
So just getting back in from the General Hospital
How's a crazy trip? Let me tell you a little bit about it in just a second
But I mean, I've just got to go to handover and handover to the team
Wow, what a crazy experience
I'm super awake and excited about it because if that person had been at home when this happened
He may not have actually made it. So, um
Wow! It was it was phenomenal to actually see them go in
Open up that artery save that person's heart and their life. So very very cool. Um just to be clear
So most times when people have a heart attack
They're at home and then they get brought to the emergency department for that heart attack
So it's really unusual that once someone's already had been admitted for a different reason that they have an acute heart attack like that
anyway
Okay, feel the adrenaline
Kind of wearing off now
Thank you so much for watching guys. It's so awesome seeing your comments. I'm looking forward to them
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So I'll see you guys next week and I'll be telling you all about my oncology or cancer rotation. So bye for now