At the beginning of my rotation in ICU, plenty of concerns started to show up. One of the most popular questions among interns is how to survive an emergency situation successfully without supervision. I must confess that I felt petrified just to think of it. Fortunately, I had always a fellow by my side until that night call shift that I will never forget. It was the case of a young female patient who was discharged 24 hours after a total thyroidectomy. Unexpectedly, this patient came to E.R. 24 hours after being discharged complaining of progressive shortness of breath and a funny sensation in her chest. Typically these patients are seen by their surgical attending, but in this case, her surgeon was in OR for 7 hours performing an emergency
…show more content…
As soon as I put my stethoscope on her chest, I noted the complete absence of breath sounds. I got paralyzed for a few seconds, but I had to face it; that petrifying moment of being unsupervised, finally came. This patient had a pneumothorax; her O2 sat was 86 and RR 29. Undeniably, this situation called for a quick decision. We did not have time to wait for the attending to evaluate her. Based on my knowledge and training, I decided to do a chest decompression. My fellow resident called the attending to tell him what just happened and he got so angry at me for doing something different to what he originally ordered. He thought I did not have the ability to do it. I felt under so much pressure after hearing what the attending said on the phone. However, I knew I did the right thing to do at that moment for the patient. Both of the procedures, decompression, and chest tube placement went uneventfully, and the patient recovered pretty well. After that, the attending who is now my friend thanked me for doing what it was supposed to do for the patient. He said, “from now on, if you face a situation like this, just do
As soon as I put my stethoscope on her chest, I noted the complete absence of breath sounds. I got paralyzed for a few seconds, but I had to face it; that petrifying moment of being unsupervised, finally came. This patient had a pneumothorax; her O2 sat was 86 and RR 29. Undeniably, this situation called for a quick decision. We did not have time to wait for the attending to evaluate her. Based on my knowledge and training, I decided to do a chest decompression. My fellow resident called the attending to tell him what just happened and he got so angry at me for doing something different to what he originally ordered. He thought I did not have the ability to do it. I felt under so much pressure after hearing what the attending said on the phone. However, I knew I did the right thing to do at that moment for the patient. Both of the procedures, decompression, and chest tube placement went uneventfully, and the patient recovered pretty well. After that, the attending who is now my friend thanked me for doing what it was supposed to do for the patient. He said, “from now on, if you face a situation like this, just do