Oh how I remember those days. I got to the point where I refused to work that much.There was much more then being richer and saving lives... Get some sleep and some of us will stand the watch!
Oh, yes. The days of double shifts then a double back where you get your state mandated eight hours between shifts then do it all over again and again and again. And they wonder why drug and alcohol use is so high amongst the folks who work the 24/7/365 jobs.
Sleep deprivation in the military is needed training, and you still see performance degradation when 18 years old. For the medical profession to put up with this seems slightly criminal to me. But of course, not knowing the circumstances, I could be missing that your city is a war zone and the medical personnel are quasi-military unknowingly drafted.
Have you tried Adderall? Personally, I find that I don't do anything well when I'm short of sleep. But then I have been diagnosed with sleep disorders.
Aesop, patient came in last night with a K of 9.1 and a creatinine of 8.9, BUN was over 80. EKG showed what looked like wide complex V-Tach in appearance, but the rate was only around 100. It was T wave elevation. Color was really bad, pressure was 90's over 30's, I thought he was going to code. Gave him Calcium gluc and a couple amps of bicarb, amp of D50 and some insulin (BG was 105), 1,000 bolus of NS. Called Lifeflight.
Dude actually came around. Color improved, LOC came up, pressure went to 110/70. Then dustoff took him away.
Any sufficiently advanced technology is indistinguishable from magic, they say.
Literally...shutdown the US Ports of Entry with Mexico to ALL traffic and pedestrians until Mexico gets a handle on this; Stop ALL foreign aid to Honduras, El Salvador, Guatemala and Mexico until they demonstrate where the hell our money is going we send them for building their economy and infrastructure. Post military assets along the entire border, with BP arrest teams, and ERO transportation. Set up family detention camps around the country to house anyone to enters illegally or claims asylum; fast track asylum and deportation hearings with onsite immigration judges; IMMEDIATELY remove from this country all frivolous asylum claims and deportation orders.
@Gray Man 1. Holy crap, I'm sort of surprised he didn't code. 2. Known renal dysfunction (I mean previously known) or was this how the poor bastard found out?
When I was a resident there was a storied patient, dialysis dependent, who decided enough was enough and that he was going to end it all. He missed a couple of dialysis appointments; someone was sent to find him, and that someone found him dead, with a big pile of banana peels in his trash and an abnormal amount of uneaten bananas in his kitchen. And a note explaining that his plan was to go out from VT. He correctly figured that between missing HD and ingesting lots of potassium (delivered via banana, for you non-medical readers) he'd go hyper-K enough for that to happen. Near as anyone could figure out, that's how he went. This sounded like an urban legend to me (for one thing, why not crush up potassium supplements rather than do the work of eating all those bananas -- I mean, how many bananas can you eat at any given time?), but people swore up and down it was a true story.
Story sounds fake to me, since you could fill you stomach five times with masticated bananas and it wouldn't push your K to lethal levels, even with renal function in the toilet.
The guy had a history of temporary dialysis. We helicoptered him out and the immediately gave him a TIVAD and dialyzed him. I was also surprised he didn't code. Who survives a 9+ K? Well, him...
Yeah, I've seen K levels of 8+, but never a 9. That's generally the lethal injection dosage threshold, and not compatible with life, but there's always the occasional exception, obviously.
Had a Skid Row diabetic with a sugar of 1343, who was coping by drinking water and literally peeing herself nonstop, and she came in walking and talking.
Sleep dude, get as much as you can.
ReplyDeleteWorking until burnout comes with a price.
We'll be here when you wake up.
Aye. Lack of sleep makes you stupid. Ask me how I know - when you awaken.
ReplyDeleteCop some zzzz's, we'll take the watch...
BG
+ 1 on what Phil said.
ReplyDelete.
We'll still be here.
Oh how I remember those days. I got to the point where I refused to work that much.There was much more then being richer and saving lives... Get some sleep and some of us will stand the watch!
ReplyDeleteOh, yes.
ReplyDeleteThe days of double shifts then a double back where you get your state mandated eight hours between shifts then do it all over again and again and again.
And they wonder why drug and alcohol use is so high amongst the folks who work the 24/7/365 jobs.
Dude: Your eyes are in screen-saver mode.
ReplyDeleteSleep deprivation in the military is needed training, and you still see performance degradation when 18 years old. For the medical profession to put up with this seems slightly criminal to me. But of course, not knowing the circumstances, I could be missing that your city is a war zone and the medical personnel are quasi-military unknowingly drafted.
ReplyDeleteSleep is good... Just sayin...
ReplyDeleteGet some rest. If you haven't got your health, you haven't got anything.
ReplyDeleteHave you tried Adderall?
ReplyDeletePersonally, I find that I don't do anything well when I'm short of sleep. But then I have been diagnosed with sleep disorders.
Six pack and some pussy.
ReplyDeleteThat'll set you right.
Ned2
Aesop, patient came in last night with a K of 9.1 and a creatinine of 8.9, BUN was over 80. EKG showed what looked like wide complex V-Tach in appearance, but the rate was only around 100. It was T wave elevation. Color was really bad, pressure was 90's over 30's, I thought he was going to code. Gave him Calcium gluc and a couple amps of bicarb, amp of D50 and some insulin (BG was 105), 1,000 bolus of NS. Called Lifeflight.
ReplyDeleteDude actually came around. Color improved, LOC came up, pressure went to 110/70. Then dustoff took him away.
Any sufficiently advanced technology is indistinguishable from magic, they say.
Figured I'd share.
Literally...shutdown the US Ports of Entry with Mexico to ALL traffic and pedestrians until Mexico gets a handle on this; Stop ALL foreign aid to Honduras, El Salvador, Guatemala and Mexico until they demonstrate where the hell our money is going we send them for building their economy and infrastructure. Post military assets along the entire border, with BP arrest teams, and ERO transportation. Set up family detention camps around the country to house anyone to enters illegally or claims asylum; fast track asylum and deportation hearings with onsite immigration judges; IMMEDIATELY remove from this country all frivolous asylum claims and deportation orders.
ReplyDelete@Gray Man
ReplyDelete1. Holy crap, I'm sort of surprised he didn't code. 2. Known renal dysfunction (I mean previously known) or was this how the poor bastard found out?
When I was a resident there was a storied patient, dialysis dependent, who decided enough was enough and that he was going to end it all. He missed a couple of dialysis appointments; someone was sent to find him, and that someone found him dead, with a big pile of banana peels in his trash and an abnormal amount of uneaten bananas in his kitchen. And a note explaining that his plan was to go out from VT. He correctly figured that between missing HD and ingesting lots of potassium (delivered via banana, for you non-medical readers) he'd go hyper-K enough for that to happen. Near as anyone could figure out, that's how he went. This sounded like an urban legend to me (for one thing, why not crush up potassium supplements rather than do the work of eating all those bananas -- I mean, how many bananas can you eat at any given time?), but people swore up and down it was a true story.
Story sounds fake to me, since you could fill you stomach five times with masticated bananas and it wouldn't push your K to lethal levels, even with renal function in the toilet.
DeleteThe guy had a history of temporary dialysis. We helicoptered him out and the immediately gave him a TIVAD and dialyzed him. I was also surprised he didn't code. Who survives a 9+ K? Well, him...
Yeah, I've seen K levels of 8+, but never a 9. That's generally the lethal injection dosage threshold, and not compatible with life, but there's always the occasional exception, obviously.
ReplyDeleteHad a Skid Row diabetic with a sugar of 1343, who was coping by drinking water and literally peeing herself nonstop, and she came in walking and talking.
Our doc, who had been a MD since the 1970's, had also never seen a 9. Apparently it'll put your T wave through the top of the page.
Delete