I wrote this explanation for interpreting arterial blood gases over a year ago, and every now and then it gets reviewed and reposted on Tumblr and makes me feel happy! Anyway, it must be a good one with all the attention it gets, so I figured…
— ICU registrar’s words of wisdom today.
itsjustcharli replied to your post: If a coronary artery in the heart is ruptured, it…Tamponade. It sucks. That’s why they keep opening up people’s chests in my ICU.
Is it a very common occurence?
It doesn’t happen all that often, but it’s one of the most serious complications when it does happen. So we’re always on the lookout. Increased heart rate and decreased BP with a low cardiac index is usually going to be tamponade. And it can cause an arrest very quickly. So they don’t even bother taking them back to theatres, they open them up right there and start suctioning.
I’ve seen it twice in the month I’ve been in CICU.
Day 3: Nursing orientation.
The orientation itself wasn’t a big highlight, but interesting nonetheless.
During lunch I went to staff health to make sure my vaccination clearance was done. They re-signed a form to take to ICU just in case it hadn’t been sent to them already. I went down to ICU and met the manager, who seems pretty nice. He then introduced me to my NUM, who confirmed with me that I have next Friday off for my friend’s wedding, yay!
So anyway, I’m in Cardiothoracic ICU for the next 6 months!!!
Exciting. The ICU department is made up of 4 parts; two general ICUs, a CTICU and a neuro ICU. We will be doing 6 months in a general, and the other 6 months is either in CT or neuro. I’m happy I got CT because it makes a lot more sense to me than neuro. And also I get to be all hardcore like Cristina Yang from Grey’s. Fun fun!
On a side note, my bird has been in hospital for the past week due to inhaling a seed. The vet called me this afternoon to let me know he’s been whistling (which is for the first time since last Thursday morning!) Such good news! They were going to have to do some risky invasive things if the seed didn’t break down properly, but this is a great sign. He’s going to stay at the vet for a few more days just in case, and then hopefully he can come home!!!
So that’s all for now, tomorrow starts with orientation within ICU itself. I’m really looking forward to it. :)
And then say “I can refer you to a social worker or psychologist.”
Yes, those professionals are ideal in the situation, but I dislike when the doctors say that straight away without any attempt at empathy themselves. ALL health professions should be holistic. I imagine being a patient and being told, for example, “you have cancer, let me contact the social worker”, is not THE most reassuring statement. It kind of says “I’m delivering you bad news, you’ll need professional help to get over this one”.
I understand that doctors are not professionals in the area of psychology and social work, but a little bit of empathy BEFORE referring patients to those specialities will go a long way.
And to those doctors that DO empathise, thank you!!!!
MDS refers to a number of conditions caused by abnormal production of myeloid cells - that is the blood cells that are formed in the bone marrow. The blood cells are usually immature and do not work as they should, and so they die in the bone marrow or shortly after entering the blood stream. It is more likely to occur in patients over the age of 60. MDS is not a cancer, but may progress to Acute Myeloid Leukaemia.
MDS may be caused by chemotherapy, radiotherapy or the industrial solvent Benzene. Often there is no known cause. Genetic disorders may cause MDS in a few cases.
SIGNS AND SYMPTOMS
Related to the symptoms of reduced/inefficient blood cells.
- Low red blood cells: anaemic symptoms such as fatigue, feeling short of breath, paleness, feeling cold.
- Low white blood cells: ineffective immunity, causing frequent fevers and infections.
- Low platelets: Increased/easy bleeding and bruising.
Often, when first diagnosed, patients with MDS do not have signs and symptoms. Abnormal blood tests showing pancytopenia (neutropenia, anaemia and thrombocytopenia), splenomegaly (enlarged spleen due to infiltration of abnormal lymphocytes), abnormal blood cells when viewed under a microscope, and chromosomal abnormalities can all lead to a diagnosis of MDS.
Supportive therapy, such as blood transfusions, is the most common treatment type. Chemotherapy may be used, particularly if MDS has progressed to AML. Stem cell transplantation may be considered in young patients.