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Friday, January 11, 2008

We RTs appreciate good doctors

We here at the RT Cave often find humor by things that might otherwise frustrate us. I suppose this is our natural way of maintaining our sanity over things we know we have little control.

You can look at the list of 'olins at the bottom of this blog to get a perfect example of what I'm referring to, or you can check out what I wrote about Doctor Krane two months ago to the day.

We are also fair here at the RT Cave, and we are more than willing to give credit where credit is due.

When a nurse calls for the rapid response team on a patient we determine to be perfectly fine, we reassure that RN that she did the right thing. And when she calls the team and we prevent a patient crashing, we give her full credit for saving the patient. After all, it was her vigilance that made us aware there was a problem.

When we have a patient in crisis, and we all perform our specialized tasks in an effort to save the patient, we all thank each other for a job well done, regardless of the outcome. We are a team. We work together to give the patient the best chance possible

As I had predicted I was busy last night because I was burned out. And just when I finished my morning treatments and found a comfortable seat, I was called to the critical care to assess an overdose patient who had just been brought up from ER.

The nurses wanted to intubate this patient, and based on gases I drew, the family physician, Dr. Morgan, gave a phone order to have the anesthesiologist intubate the patient. I was informed that Dr. Morgan was on his way in.

The gases he based his decision on were this: pH 7.28, CO2 52, PO2 111 on 5lpm.

"Call Dr. Krane," I said. "We need a doctor now, not in a few minutes. We need need this patient to be assessed by a doctor right now."

I knew Dr. Krane had the patient in ER the past 12 hours, and, despite how many frivolous breathing treatments she orders, she is excellent in these types of situations. She doesn't do overkill.

Dr. Krane came up, assessed the patient, and impressed me with this statement: "I'd be more than happy to intubate this patient, but I think she will be fine if we just be patient. I mean, I don't know how aggressive Dr. Morgan likes to be, but I don't think we need to be aggressive in this case."

"I'm very impressed," I found myself saying, "I absolutely agree with everything you said."

It was totally unlike me to say this, but I couldn't let this opportunity pass. She was modest about what I said, but I could see the glee in her eyes.

Unfortunately, the patient's family physician wanted the patient to be intubated, and when he arrived an hour later, and Dr. Krane returned to her cave, that's exactly what happened, even though repeat ABGs showed the patient was improving: pH 7.35, CO2 48, PO2 52 on 30% venti mast. (The oxygen here was low, but that could be resolved with more oxygen.)

However, I'd like to take this opportunity to thank Dr. Krane for her brilliance in critical situations, even though she has no clue I'm writing this blog, and I'm using a fake name for her.

I absolutely appreciate doctors who look at the whole picture rather than just a number.


Glenna said...

OHMYGAWD! I can't believe they intubated a 7.35!!!!! They could have corrected that with a couple of hours on a BiPap or vigilant use of an EZPAP and an SMI over the next 48 hours! It was ONLY a 30% venti.

That's nuts. :-)

Terry at Counting Sheep said...

And shame on that doctor to intubate this patient! Maybe HE should be intubated sometime with gases like that.

Djanvk said...

Those gases are really not that bad. What was that Dr. Thinking. CO2 was only 52 with a 7.28 pH, easy fix with maybe some bipap.

triangle said...

I wanted to express my appreciation to you for being an RT who cares. I realize my comments are not related to your blog. However I spend two years continously in a hospital with my mother after a horrible medical error. My mother was set on fire during a Trach procedure and suffered. Almost all the RT's I came in contact with were GREAT!! I have a great appreciation for RT's and how they spent so much time making sure I understood what was going on. I could never thank them enough.

Founder of

Freadom said...

Sorry you had to go through that, triangle. Your kind words about RTs are very inspiring, and you made my night.