Was all it took for my nice quiet shift to go absolutely mad. One patient aspirated her dinner literally just after her SALT assesment and said she could eat (speech and language therapists do swalloing assessments in UK hospitals. No idea if it’s the same else where!). On top of that the lady opposite her went septic in an hour and had a temp of 39.4. Queue fast bleeps for medics and anaesthetists and my bay being a scrum of people!
I did see a lot of things that I haven’t before and I think I may have to seriously look at anaethetics in the far distant future. Obviously have the small matters of getting into medical school and graduating first haha! Text heavy post but writing things down is a very cathartic exercise I find!
Hope everyone had good days :)
A huggeee kidney stone!
X-ray depicting cardiac herniation
The first thing I thought when I saw this photo is “Cool, this patient has situs inversus (mirror image organs).” But no, this is actually cardiac herniation. The patient sustained trauma and presented with life-threatening hypotension. It was suspected there was a puncture, but no. Whatever trauma this patient sustained caused the heart to twist around, puncture through the pericardium and twist off the blood flow through the aorta. Because of that, the heard was swollen and filled with blood that wasn’t able to eject. The nerves were still intact (thankfully) so they just twisted the heart back around and closed the pericardium so the heart couldn’t twist around again.
This patient presented with a stab wound to the chest. “Intraoperative photograph showing open pericardium with a small (2mm) injury to the right heart. The injury had stopped bleeding and did not require further repair. This was a non-therapeutic sternotomy.”