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Old 09-07-2018, 03:35 PM
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jedimaster91 jedimaster91 is offline
Injector of Radioactive Things
 
Join Date: Jun 2008
Location: In my world
Posts: 1,388
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Oh boy was yesterday fun.

Guy comes in for chest pain, gets ordered for treadmill stress. Well, he's not real steady, so maybe chemical stress would be better. No big deal; we switch stuff like that all the time. Can't use Drug1 because he's actively wheezing. Don't have access to Drug2 (and haven't for years because we didn't have a nurse to give it). Nurse Practitioner gives the guy the choice of try to walk, cancel the exam, or transfer to another facility that does have access to Drug2. Guy says he'll try to walk.

Good news, he's older, so his target heart rate we need to get is lower. Bad news, Guy is suuuuuuuper unsteady. More bad news, his EKG is wonky. He's basically hovering between first and second degree AV block (a delay in the top and bottom chambers of the heart talking to each other) with some extra beats (both PACs and PVCs) sprinkled in for good measure. In short, I don't wanna stress this guy. The chances of Bad Things(tm) happening is more than I'm comfortable with. But such things are not up to me. Nurse Practitioner and Burly Nurse are on either side of this guy holding him up on the treadmill and he's walking like a cat with booties on. I'm hooked up with my syringe getting ready to do my thing and also have my other arm wrapped around Guy's waist.

Well, the inevitable happened: Guy took a bad step and stumbled. Burly Nurse saved the day by catching him before he fell completely and out of the corner of my eye, I see the EKG go bananas. It looked uncomfortably like Torsades in the moment, which is a VERY Bad Thing, but turned out to be an unsustained run of V-Tach. Still a Bad Thing, but not Quite As Bad as I first thought. So what might have happened is Guy's heart rate shot up, which caused him to start passing out, which caused the stumble and near fall. Or the stumble and near fall caused his heart rate to shoot up. Chicken or egg, it doesn't really matter. But it did get his heart rate up to where we needed it to be and we were able to finish the test. Thankfully, there were no further issues.

I have a feeling now that Burly Nurse is here, we'll be getting access to Drug2 in the very near future. Which I'm not super stoked about because I hate Drug2 (it takes forever to work and makes people feel really crappy for a long time), but such is life. Sometimes we need it.
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I am no longer of capable of the emotion you humans call “compassion”. Though I can feign it in exchange for an hourly wage. (Gravekeeper)
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