A few days ago, we had VSA come into the department. According to EMS, the patient had collapsed while grocery shopping down the road; CPR was started almost immediately by another shopper; EMS arrived and gave the usual ACLS drugs — epinephrine and atropine, as well as defribrillating him, but the only rhythm showing  on arrival was ventricular fibrillation. We shocked the patient again as soon as soon as we offloaded him onto a Resus Room bed — and (somewhat to the team’s surprise) the patient reverted a sinus rhythm with a palpable, if faint, femoral pulse.

Then the real work started to preserve circulation: intubation to manage the airway, peripheral IVs, drips of various inotropes and antiarrhythmics and sedatives to be set up, a central line and central venous monitoring, an arterial line,  foley catheter, and (at the same time) beginning the therapeutic hypothermia protocol, to preserve the brain from ischemic injury. Therapeutic hypothermia is itself  immensely complicated to implement, involving ice packs, iced saline boluses and iced continuous bladder irrigation to lower core body temperature below 34C.

As we were rolling the patient up to the ICU, I stood outside of myself for  moment and thought, “This was all pretty awesome. We have given this poor guy a chance to live. I have a really awesome job.”

And when we transferred the patient into his bed, he began opening his eyes. We weren’t sedating him enough. But that was pretty awesome too.


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  1. #1 by The Nerdy Nurse on Saturday 19 November 2011 - 1230

    Awesome is the best possible description of the even above. How amazing that you SAVE LIVES. It’s pretty remarkable when you step back and think about it.

  2. #2 by Maha on Saturday 19 November 2011 - 2320

    This is why I keep going back to work over and over again! Despite all my snarking I love what we do.

  3. #3 by Jenn Jilks on Sunday 20 November 2011 - 0748

    It is awesome. I so agree with your integrity, your attitude, and respect for self, others; patients (of course), staff, and those who do their jobs well. Great post.

  1. Best In Nurse Blogs: Thanksgiving ER Visit Edition! | The Millionaire Nurse Blog

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