Lumo Blog!

I was in assessment bay, which is where all the patients come to before they go into majors. They have a quick nurse assessment, obs and an ECG (if necessary), then they go round to the main majors department and into a bay. There are 20 bays, so it holds 20 patients at any one time. The problem was that majors was full, and we had about twice as many patients waiting to go into bays, with more flooding through the door. During our busiest half hour, we had roughly 8 chest pains, loads of head injuries, overdoses and abdo pains; they'd been through us in assessment bay and were waiting to go into majors. Chest pains usually come before anything else (except for one of the patients who had an arterial bleed from his head). I was ECG master.

At 22:00, and all within the same minute, a woman collapsed with chest pain in reception, and another patient started having a grand mal seizure in our assessment bay. While this happened, I was doing an ECG on a gentleman, which showed he was having an acute MI (heart attack). Shit. We got a nurse to assist the collapse in reception, and while that was being sorted I was showing the ECG to a doctor in resus and trying to find a nasal pharyngeal airway (NPA) for the fitting woman. I was told;

'Do nothing else - get this man into resus now'

'Which bay?'

'Oh shit, there's no room'

*that's right - doctors swear too*

They had no choice but to move someone in resus out into majors, I don't know how they found room in there.

There were no nasal pharyngeal airways. It was ridiculous. I looked everywhere in majors and resus, and there were none. Bollucks. I asked a nurse for one, and she handed me an ET tube *see terrible drawing*. Are you joking?! I can tell the difference and I'm not even able to put one in. There was nothing I could do, I told the nurse there weren't any and I wheeled our man with the heart attack round into resus, while the lady who'd collapsed with chest pain in reception was put into that place. Her ECG looked fine, but she'd need more tests, especially as she was in so much pain. I didn't find out what happened to the patient who was fitting, the nurse was taking care of her so I got onto sorting out the other 7 chest pains. All the while, we had people in with head injuries, ODs and abdo pains waiting opposite. They were watching intently, that must have been some great friday night entertainment.

Our friendly patient with the arterial bleed from his head was shouting out that he needed to be seen first, and he was right. There was blood literally spurting out onto the floor. He'd been the victim of an alleged assault, and was in a bad way. I looked through the drawers for a dressing;

'Oh look - there's an NPA!'

Given that the patient who needed it had since moved round and been seen, they weren't amused. I was.

We had an unresponsive patient come in, a 40 year old female who'd taken an overdose. Her teenage daughter was with her. I went to find an OPA in resus. I chose not to ask that nurse where one might be, and asked a doctor;

'Sorry to bother you, but do you know where I could find an OPA?'

'An OPA?'

'Yeah'

*pause*

'An oropharyngeal airway?'

'Oh, well if it's an airway it will be here in one of these drawers'

What is wrong with our staff?!

It didn't stop all night. Just when we were getting through the numbers, and there were only four left waiting, more came through the doors. The two nurses I was working with were so stressed, one wanted to go home. I was loving it. It probably sounds really strange, and I got a dodgy look from them when I said it, but I actually think I work better under pressure. It gave me so much drive, they couldn't believe how fast I was getting through them. I really was ECG master.

My shift started at 9pm and finished at 8am. We had two in assessment bay at 7:30am, half an hour before I was due to finish, and that is the least amount of patients we'd had with us all night. The blood was still on the floor when I left. I am so glad I wasn't in the main majors department, it was pandemonium.

All in all, it was a fantastic experience, and I was actually told that they couldn't have coped without me. I've been there for 6 weeks. This is definitely for me.