i'm right there if you get lonely, give this song another listen, close your eyes, listen to my voice, it's my disguise, i'm by your side..
I was almost certain I sang that Delilah song in my head while I was writing the medical notes at the desk when one of the doctors there suddenly started following my tunes. Erkk. I turned my head up and there he was smiling away. That Delilah song is seriously haunted. This could be very cliche or I could just possibly be hallucinating post-call.
Moral of the story is not to use the song as your alarm tone in the morning OK. Especially when you're on-call.
We have one patient who was admitted with severe CO2 narcosis with initial pH on the ABG of 7.19 (severe acidosis). He was refusing treatment while trash talking to the SHO, who apparently lost his coolness and started pointing out the fact that he might well be dead if he didn't start using the NIPPV machine right away. So he did. And the blood pH and CO2 recovered.
Today the night staff reported that he was refusing the machine again. We spoke to him, literally had to bargain about his life-threatening actions. After few different chats with him and the family, we came to conclude that he wanted comfort measures with minimal interventions. That means he can refuse treatment as he wishes and we'll respect that decision.
I went to do a repeat ABG on him. He was zonked, I'd say from the accumulating CO2 in the blood. Literally had his eyes rolled up and arms twitching and flapping intermittently. I was talking through to him while poking the needle in, not sure he listened. Before I left I heard he said, "Say your prayers to Allah for me please." I halted, not sure I was listening correctly. "Pardon me?" And he repeated the same words.
The last time somebody said that to me was Mr Smith. And he died not long after. Man..
Moral of the story is not to use the song as your alarm tone in the morning OK. Especially when you're on-call.
We have one patient who was admitted with severe CO2 narcosis with initial pH on the ABG of 7.19 (severe acidosis). He was refusing treatment while trash talking to the SHO, who apparently lost his coolness and started pointing out the fact that he might well be dead if he didn't start using the NIPPV machine right away. So he did. And the blood pH and CO2 recovered.
Today the night staff reported that he was refusing the machine again. We spoke to him, literally had to bargain about his life-threatening actions. After few different chats with him and the family, we came to conclude that he wanted comfort measures with minimal interventions. That means he can refuse treatment as he wishes and we'll respect that decision.
I went to do a repeat ABG on him. He was zonked, I'd say from the accumulating CO2 in the blood. Literally had his eyes rolled up and arms twitching and flapping intermittently. I was talking through to him while poking the needle in, not sure he listened. Before I left I heard he said, "Say your prayers to Allah for me please." I halted, not sure I was listening correctly. "Pardon me?" And he repeated the same words.
The last time somebody said that to me was Mr Smith. And he died not long after. Man..
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