Condition C

Long day = short update.  Seems I was unfortunately right about the patient I mentioned last night.  At first, it seemed like things were going much better today...he was more with it, alert, oriented, communicative.  But as the day wore on it became clear that some things just weren't quite right.  He was still running fevers despite being on antibiotics.  He was still breathing too quickly.  His heart was beating even faster than it was yesterday and it just looked ugly on the monitor...lots of PVCs, atrial fib, even non-sustained v tach. (Non-medical people: if you're really interested, you'll have to ask for a specific translation, because this one requires a lot of explaining.)  And then his IV blew.  And the IV team couldn't get access.  And he started having longer runs of v tach.  And his temperature went up.  Without an IV we couldn't give him fluids, antibiotics, beta-blockers to control his heart rate, anything.  So after ascertaining his code status with his power of attorney (my first time getting a code status on my own...more about that next post) I grabbed my intern and attending who decided to call a Condition C.  Long story short, by the end of the day he looked pretty bad and was getting a central line from the CCM fellow.  It's probably about 50-50 whether he ends up in the ICU overnight, and if that happens...well, we'll cross that bridge when we come to it, but I'm afraid it'll work out poorly.

So yeah, that's the update for the evening...wish it were a happier one.  Now I'm off to grab a few hours of sleep before long call tomorrow.  *Sigh*  Till next time, peace and God bless!