Tuesday, June 3, 2008

ANAPHYLACTIC REACTION

I was sitting at the front desk fixing to discharge a patient when registration crashed through to the back saying someone has to come out here and help these two men who have a friend who can't breath. They think it's an allergic reaction to two ALLEVE he took. Well were the hell was Misty who was supposed to be in assessment waiting on just that scenario?

So out I run and slumped in the wheelchair is a late 30'ish man with dilated pupils and a snoring, gurgling;(BAD) respiration. I had him in the wheel chair supporting his airway with the jaw thrust maneuver while trying to find an open room. On the way I had the s-tube (an airway and bite stick that keeps the tongue out of the way, opens the airway and allows suction at the same time. I did not have time to place it as he vomited and I quickly turned his head to the side and did a finger sweep to keep him from aspirating. At this point he was Chane-Stoking and was blue from nipples up. Not what you want to see. We hauled ass to a room and I did a fireman's carry and lifted him over the wheelchair and onto the stretcher. We'll talk about the back pain another day!

On the stretcher, he regained some of his respirations and was able to start verbalizing things to us. I relaxed at that time and went for a non-rebreather mask- some nunb nuts had pulled out a cannulae!!!!
I pushed him up to 15 liters and with in a minute or two his O2 sat was 98% with his tachypnea slowed from 36 to 24 and a pulse of 158 to around 120-100. He had an 18 jelco in his Rt ac within 30 seconds and 3 cc of Epi IM vs sub cu. The ER Doc said the IM was actuality faster than sub cu, well it worked. He responded beautifully and was subsequently sent home in stable condition.

This is a beautiful picture of the dance that goes on in a semi critical situation. No one freaked, we did what we had to do in an incredibly efficient and short time with outstanding results.

I told him to take two Alleve and call me in the morning!

Medical ballet at it's finest! A dance of life with everyone knowing their rolls were and not a word spoken. Ok a few words, BP---80 paplp, Trendelenberg?; YEP, and get me the epi!


John