CODE BLUE

It's going to be a very post happy day! After some nudging and hinting on Stuff's part, I've decided to get my act together and post (after a long hiatus - see Stuff's most recent entry for excuse) about the Code Blue event Cramberry and I just attended in the ICU department.

We walked into the ICU conference room to see 1.5 plastic dummies and 2 cookies on the table. The cookies were left over from another meeting earlier in the day and have no relevance here, I mention them only because I was near starvation at the time and couldn't stop looking at them as my blood sugars dipped into hypoglycemic territory. I say 1.5 dummies because one was only half a dummy: torso and head with no legs or arms. The other one (with all appendages intact) was lying next to a crash cart (defibrillator + pharmacy + medical supplies on wheels). There were 10 medical students in attendance, all there to learn how to 'run' a code blue from an ICU doctor.

Dr. B started by walking us through all the components of the crash cart: how to turn the defibrillator on, adjust the voltage, slap gel pads on the dummy, apply the paddles, yell "CLEAR!", press the orange buttons, check rhythm, etc etc etc. (You know, exactly like how they do it on TV). She also went through all the components of the drug box: atropine, epinephrine, amioderone, lidocaine... basically the entire pharmacology section of our cardiology block in a little metal box (Stuff would have loved this part. Me, not so much). There are also two little bright orange pylons on the crash cart to put outside the doorway of the patient's room - just in case the hordes of people within weren't enough indication of a code blue situation.

We then split into two groups of 5. Each group had a leader, a drugs person, the electricity person, a chest compressions person, and the airways person. We took turned running codes on the dummy (popular codes include... "patient is awake and talking with slow heart rate!", "patient has pulseless electrical activity!", and "patient has arrested and is in ventricular fibrillation!") for about an hour. I got to be chest compressions person and electricity person for 2 separate cases. Unfortunately I didn't get to do the "CHARGE UP TO 200V! EVERYONE CLEAR!" spiel all us baby-doctors dream of yelling out - the case in question was of a bradycardic (slow heart rate) patient who needed pacing... so all I got to do was unplug the paddles and plug in the pacing pads. Boourns.

On the plus side, I did get to practice intubating on the 0.5 dummy at the other end of the table - the trick with intubating is to slide the metal laryngoscope into the mouth and stop just in front of the epiglottis (flappy thing over tongue), then push out HARD without chipping teeth or breaking any laryngeal cartilages to expose the arytenoid cartilages, then slide the tube into the trachea without going into the esophagus. I did it! It was glorious. Hurray for me! Hurray for 0.5 dummy!

Oh, and in case anyone was worried about my hypoglycemic state, Dr. B ordered us pizza for dinner. It was good. And that my friends, is how a fake code blue is run.

Countdown to X-mas break: Still 3.5 weeks!

Everyone poops ... and pees too

...unless they have some obstruction or neurogenic condition, but then I guess it'd be more of a dribble, constant flow or... uh.. too much info?

So, as you can sort of guess, these past few months have been our bodily function blocks, otherwise known as Gastrointestinal and Genitourinary. Intestines and kidneys! Diarrhea and constipation! Poop, pee, poop, pee... and more poop! Hurray!

Okay, so I know there's more to it than that. Obviously... it's part of the reason why we've been MIA for so long. Sorry! We're okay, we've been here, just stressed and overwhelmed with lectures and assignments and exams and research projects, and life... but surviving though. The courses have been intensely detail-oriented, and GU especially has been particularly cerebral. Take today's lecture on proteinuria, or protein in the pee, as an example: there are two types, micro and macro, which may be transient, orthostatic or persistent. Now, persistent proteinuria can have 4 different kinds of proteins excreted, one of which is glomerular proteinuria, which can have primary or secondary causes which in turn have their own bazillion possibilites, etc, etc... You get the point. And that was only HALF the lecture! We still had to go through hematuria (blood in your pee) which had its own long, convuluted flow chart... kinda like glomeruli and nephrons! (Oh gosh, I'm nerdy). I felt like I was in a real-life choose-your-own adventure story, except every story seemed to end in glomerulonephritis. I guess it is as the docs love to say, "Clear as mud, no?"

Along with all these brain-frying lectures have been our clinical skills sessions. They've mostly been really helpful and help us consoldidate what we've learned (or were supposed to have learned last year... *cough* MSK *cough* anatomy) thus far. And all the docs (specialists in whatever speciality we're learning that week) have been really good... at least when we've had them (let's just say our pediatric sessions were spent mostly playing with the cute babies, and when asked by the parents whether we wanted to examine anything, it was replied with a prompt 'Uh no, that's okay.')

One thing about the ever-prepared medical student in clinical skills is that I get asked a lot for supplies. Paper, gum, pens, highlighters, and hand-cream. Yeah, hand-cream, because all that hand-washing and MRSA prevention does make one's hand get kinda rough. I shouldn't be surprised, but I just didn't anticipate from my guy colleagues (boo...how sexist of me!). At today's cardio session:

S
Hey Stuff, do you have hand-cream I can borrow?
Stuff
Sure... uh, but it's scented. Is that okay?
S [hesitating slightly]
Scented?... like girly scented?
Stuff
Um... yes, yes it is
S
Uh..... it's some fancy pefumey stuff isn't it? Okay, well thanks anyway.
[30 seconds later]
S [looking at his hands]
Actually, can I get some of that?
Stuff [handing over the lotion]
Sure!
Dr. Cardio
Okay guys, let's go examine the patient
[S walks out first, a scent cloud of Vera Wang by Vera Wang trailing]
S
Oh man
Stuff
Hey at least you've got supple skin now

So if you ever smell a bunch of med students smelling like Vera Wang, well you know where they go it from.


P.S. New skill I have perfected this year.... sleeping in lecture... I am awesome at it... Truffles, what with your grunting yourself awake and dreaming about clapping in class, have some practicing to do. =P

Countdown to X-Mas Break: 3.5 weeks!