Intern Years

Gone In Sixty Seconds

(Gone in Sixty Seconds, Trevor Rabin)

*

"Okay, it's been four hours, Carla's serum sodium level is 131 mmol/L, and her clinical status has improved further," Dr Goodwin said, "In a few hours, she should be ready to be discharged."

Dr Goodwin and Con left her room and walked down the corridor.

"Okay, you're on my service for the rest of the day. Let's go down to the ER." Dr Goodwin took Con down to the pit.

The pit was hectic, as it nearly always was.

People were being rushed around on stretchers and everyone was making noise.

"What have we got?!" Dr Goodwin yelled.

"Sixty five year old, Mr Franklin has a history of hypertension, depression and chronic pain from failed back surgeries from lumbar radiculopathies." One of the Paramedics yelled, wheeling a trolley.

"Okay!" Dr Goodwin grabbed the trolley and wheeled it into a room.

"I'm his wife!" a woman wailed, "I'm a nurse, I found him lying on unresponsive by the side of his bed, about twenty minutes ago, After i returned from my night shift!" 

Con vaguely recognised the woman.

"I checked his ABCs and thought i noted a faint pulse and shallow breaths. I called emergency services, and then i went back to my husband." She exclaimed, "And then i felt that he didn't have a pulse and he was becoming slightly cyanosed. So, i started CPR with thirty compressions and two breath cycles. And soon after the emergency team arrived."

Dr Goodwin noted a faint pulse of about 120 beats per minute. His respiratory rate was very low, so she continued bagging to keep oxygen saturation above 95%.

His systolic blood pressure was 68 mmHg, and both pupils were normal and reactive to light.

The paramedics had also secured his spine, and started IV fluids en-routine. his capillary glucose was found to be 78 mg/dL.

He was also responsive to pain, but not to verbal commands.

Mrs Franklin tried to maintain her composure and provided her husband's medical history and medication list.

"He's on Hydrocodone and Acetaminophen 10/325 mg QID, Morphine ER 30mg BID, Lisinopril 40 mg daily, Duloxetine 60 mg BID, and Ranitidine 150 mg prn. There is no history of diabetes, recent changes in his medication, or suicidal." Mrs Franklin said, frantically.

Mr Franklin was still being bagged at this moment, but he had good color.

"His vital are as follows: temperature: 37.8 C, pulse 100 bpm, blood pressure 80/50 mm Hg, 02 saturation 98%" Dr Goodwin said to Con, "His heart exam shows a normal rhythm, without murmurs or gallops, and no edema in the extremities. his lungs sound clear bilaterally, and the abdomen is nontender."

"We're going to give him Naloxone." Dr Goodwin informed Mrs Franklin.

Mr Franklin stabilized. 

Dr Goodwin proceeded to further examine him, and request the relevant lab tests.

Con Dr Goodwin left to check up on some other patients.

"Dr Miller, I have to give Carla Smith the discharge papers. Go and check on Mr Franklin, okay?" Dr Goodwin sent Con.

Con went to inspect Mr Franklin.

As Con was examining him, he woke up, but he was confused and started to ramble.