Float Nurse

Ah, Bravo! Bull! The crowd roars! The bull goes, he comes, He comes and strikes again! Shaking his dart-stabbed neck, Full of fury, he runs! The arena is full of blood! They save themselves, they pass the gates It is your turn now. Let’s go! En guard! Let’s go! Let’s go! Ah! Toreador, en guard! Toreador, Toreador! And dream away, yes, dream in combat, That a black eye is watching you, And that love awaits you, Toreador, Love awaits you! Escamillo's Aria from Bizet's Carmen 1805:  A 50 year old man is brought in by EMS with complaints of difficulty breathing and generalized weakness.   He has a history of cardiomyopathy with EF 15%, CHF, ascites, and diabetes.    1815:  He is placed on the monitor and oxygen is continued at 4L/min via mask.   His initial oxygen saturations are 96%.   An IV is established, a 20 gauge in the right AC, and labs are obtained”  TNI, BNP, Chemistries, CBC, DDi...

Life is pleasant. Death is peaceful. It's the transition that's troublesome. Wise Phrase by Isaac Asimov 1016 PM:  A 27 year old female is dumped out of a car in the entrance to the ER.  The car drives off.  She is unresponsive with agonal breathing.   She is placed on a stretcher and rushed to the trauma room.  During her assessment she is noted to have a white powdery substance around her nostrils.   Her pupils are constricted and nonreactive.  Her skin is hot and dry.  The peripheral pulses are weak with delayed capillary refill.   Positive pressure ventilations are started and she is placed on the monitor.   1022 PM:  An IV is established and blood specimens are obtained.    Spontaneous respirations and her pulse is now absent.   CPR is initiated and Epinephrine 1mg IV is given 1026 PM:  CPR continues with positive pressure ventilations.  IV fluid bo...

"And, has thou slain the Jabberwock? Come to my arms, my beamish boy! O frabjous day! Callooh! Callay!' He chortled in his joy. JABBERWOCKY  by  Lewis Carroll 1500:   An 82 year old female with pneumonia and exacerbation of  COPD.   Monitor alarm heard for heart rate less than 50.   Patient found unresponsive with agonal breathing.   Rapid response called.   Positive pressure ventilations given to the patient.   No improvement in patient with ventilations.   Unable to obtain pulse.   Code Blue called. CPR rhythm  1506:  Epinephrine 1mg IV given.  CPR in progress with positive pressure ventilations. CPR rhythm 1508:  Rhythm check.   No pulse detected. PEA rhythm CPR rhythm 1508:  CPR in progress.  Difficult to ventilate.  Abdomen very distended.  Nasogastric tube inserted and stomach decompressed.   Ventilations improved. ...

Because I could not stop for Death— He kindly stopped for me— The Carriage held but just Ourselves— And Immortality Because I Could Not Stop for Death- Emily Dickinson 1500:  A 50 year old female who collapsed at a local retail store was brought in by EMS.   CPR was initiated at the scene.   She was found to be in pulseless ventricular tachycardia and she was defibrillated twice and received an initial dose of epinephrine.   No family members or friends were available to relate her medical history.   She has no prior hospitalization so no medical previous medical records are available. 1514:  CPR is in progress as EMS wheels her into the trauma room. 1515:  She is transferred from the EMS stretcher to the ER stretcher.  CPR is stopped for an initial rhythm check. Initial rhythm:  AV dissociation 1517: A pulse is present but she has no visible respiratory effort so positive pressure vent...