Ever since he began blogging, I’ve been fascinated by Charity Doc’s dramatic ER stories at his blog, Fingers and Tubes in Every Orifice. At first I thought, in spite of his illustrative anecdotes, that he must surely be exaggerating slightly in his title. But no; that’s what ER, and surgery too, is really about. (I know this now, because the medical student is so useful an instrument for doing the sticking.) And not only do you have to stick fingers and tubes everywhere, but then you also have to check on the results. This was brought home to me this morning, when I checked on the lady who had the esophageal repair yesterday. She was left with a Foley, a chest tube, and an NG tube. While rounding on her early in the morning, aspiring to read all of her nurses’ notes and labs, look at her, and write a note before the resident appeared, I remembered to check urine output (adequate), and observe the amount of drainage from the chest tube (minimal, but bloody). However, I think because by this time NG tubes look like normal anatomy to me, I forgot to check the NG’s suction canister. Of course, that turned out to be the major issue for her – since there was no output whatsoever. The resident spent ten minutes flushing water down it, to see if it would come back (to the patient’s and my distress), and then ordered an xray to check on its placement. . .

So, tomorrow morning: tubes everywhere, and check on them! I guess they put them there for a reason. Apparently the stomach goes on making secretions, whether anything comes down to it or not; so even though she wasn’t eating, the NG ought to have drained several hundred ccs since her operation.

Advertisements