I loved ER!

Well I am sad to say that my ER rotation is over. I really had a good time and learned a lot. I got to do some good procedures in my last week. The last day I spent in the EDx with Karen was awesome. I got to do a paronychia w a digital block, an ingrown toenail w a digital block, an I & D on the sole of the foot w a local block, and an effusion aspiration of the knee w local block. I also did some splinting and other regular sort of exams too! So for all of these procedures I was able to do them BY MYSELF :) This made me feel like Karen really trusted me to do them and to take care of the patients properly.
My last day was with Brian and my last patient was kind of sad. He came in with A fib and chest pressure and some pain in his shoulders which progressed into runs of PVC's. About 10 minutes later he was very pale and diaphoretic. A new EKG showed ST elevation, so we intubated him and sent him upstairs to the cath lab....but he didn't make it. He passed away in the cath lab from a total LAD blockage. He already had 4 drug eluting stents in his heart, but the blockage was up high in the LAD above the bifurcation so a large part of his heart was occluded and there wasn't anything that could be done for him. This was a difficult case, but a good one to learn from.
OH YEAH! I forgot to talk about the dog bite lady in my last post. She broke up a fight between her doberman and lab and had a TON of dog bites on the right side of her body. Her wrist and ankle were pretty swollen with puncture wounds on it, and I thought that she may have some fx's so we got some x rays. Sure enough she had an ulnar avulsion fx from the dog bites, and needed surgery to take care of the Fx. This was a good case, and I got to help clean out the puncture wounds and splint her arm.
So overall I really liked ER. I liked seeing all the different things all the time and being able to order tests and drugs and do procedures.....It was GREAT :)