CPR or CRP?

Ok, so I had a clinical on Tuesday in the Cardiac ICU, as stated earlier on this very blog. Anyways... it went quite well. In fact, I had quite an experience. The nurse I was with was caring for 2 patients. One of these patients was really fat and lazy and never moved. This fat, lazy patient needed surgery (Coronary Artery Bypass x3 to be exact) but was turned down because he was lazy and didn't move. It is impossible to recover from a surgery if you don't move. So they sent him to the cath lab to put stents in his Coronaries instead of bypassing them. So...

Here we are in the cath lab watching a routine procedure. There is the physician, the scrub, another guy helping out, and the lab tech that I was with back in the watching/monitoring/documenting area. Suddenly we see the patients heart stop. Yes, it stopped. Just like on the movies.

The tech sitting next to me in charge of documenting (a 10 year Resp. Therapist turned cath lab dude) jumps up and yells "He's blocked!" and runs into the lab. At this point 2 things happen. 1) I jump out of my seat and look around waiting for someone to tell me what to do, and 2) realize that CPR (cardio pulmonary resuscitation) should really be called CRP (crap right in you pants). I did not do this, however. [see previous notes on Dr. P's blog about emergent situations and pucker factors].

The tech that ran out of the room started to hook up the defibrillator while a tech from the next room ran in and started CPR. Ya. The scrub points at me and starts asking for various items from the shelves that he cannot grab because he is sterile (not that he can't have kids - he has gloves and gown and everything on). I gladly comply.

Soon enough the patient re-stabilized and everything was semi-back to normal. The techs muttering about how this patient shouldn't even be here, etc... I am back in my position with the tech monitoring when the physician says, "get RT in here - we're going to need CPR." The tech sitting there looks at me, "go do CPR." I put down my bagel and say, "uh, ok." and run out and start compressions. RT arrives shortly and intibates the patient. This equals me not doing mouth-to-mouth. I know you are all disappointed, but I did do compressions. Was it awesome? Yes. More techs and the nurse started filing in to help. CPR was stopped and I was asked to 'bag' the patient. For those you not named Dr. P. this means deflate the bag of oxygen that will be delivered to the non-breathing patient (this is a continuous deal). Was it awesome? Yes.

As I am sitting there breathing for the patient, an external pace maker was inserted as was a swan-ganz catheter. Very cool. Hadn't seen that done. Finally, the patient was transferred back to the CCU. After about an hour, the patient was stable, sedated, but stable. I drew some labs from the art line and swan-ganz, and continued to help my nurse. Was it awesome? Yes.

So, that was really long, and Dr. P bags patient every day, but this was my first experience and I thought I would share it with whomever cares. It was a bit long, but there were some details left out. Hope you all made it this far.

If you are still reading and you don't really care about any of this... I ate at Tucanos today. You are all jealous.