It's Alllliiiiiivvvvve!

Yup, I'm still alive. I knew it'd been a while since I've posted, but I didn't realize how long.
I've been so busy lately with hospital time and work and stuff that I hardly know which end is up.

I've done my time in the burn unit, which was morbidly awesome. I learned alot about burns and I was fascinated with some of the treatments and information and stuff...
There were 3 pts there when I went for my rotation.
One was a kid with 3rd degree water burns on his legs and backside and arm. I felt bad for him. Supposedly he had started his own bath, forgot to turn on the cold water with the hot, then jumped in and got burned. I thought that sounded like a feasible story until i found out that the kid can't walk. So something smells fishy there. I got to help with the bathing and bandaging on him. He had been in the unit for about a month when I was there and had already had the grafts and everything... most had taken, a few spots hadn't. What really kinda got me fried about this kids situation is that this is his 2nd time in the Unit. When he was 4, he supposedly "jumped in the bath he had run" and had 3rd degree burns, boot style. this time though, he "Jumped in and sat down". Once i heard about the mom, though, i think it's more likely that mom was baked or somethin, started the bath, forgot the cold water, and threw the kid in there. Sad stuff.

Another guy in there had 2nd degree flame burns on his chest, back, shoulders, face, and head.
He and some friends were at his garage when they heard something. When they went to investigate, they found some guys trying to steal gas. When the perps became aware of the owners presence, they promptly threw the gasoline on him, followed by a match. Those burns were pretty fresh. I was there on a Tuesday and that had happened the previous Saturday night. He was on a Fentanyl drip, i believe the dose was 7.5 mcg/hr along with a demand dose of 15 mcg available every 8 minutes... I'll have what he's having, minus the burns.
Anyway, they had applied pigskin to his burns. I guess that's the new thing for 2nd degree burns. Cover it with pigskin, and as the skin below it heals, the pigskin lets go of the skin. So when we cleaned the guy, the nurse was trimming the edges of the pigskin, then cleaning the guy. He had me help apply the ointment and stuff... I think they used Silvadene (sp?) then put on the dressings. I also watched the Physical Therapist run him through the basics to get the skin exersized and stretched and stuff.

The 3rd guy was really bad. He was an older gent, had been working on a farm tractor, was pouring some gas into the carbs or something like that, spilled some gas, and as luck would have it some wires contacted or something, lighting the tractor, and him, up. He had 3rd degree burns over 48% of his BSA (body surface area), almost all from the belt line up. His face and head was mostly 3rd, some 2nd. His chest and abdomen were all 3rds, his calf had a 3rd, his back had 2nd and 3rd, one hand had 2nds from the mid-forearm down, and the other arm was 3rds from the shoulder to the fingertips. his left hand was completely mummified.
I got to watch the surgery on him. They had already grafted his chest and abdomen, but alot of it did not take. I really felt bad for him because he had a DNR, but the family had it lifted for the surgery. Honestly, if i was burned that bad i'd probably be asking for the shotgun instead of 911... I don't know. I know there are miracle cases out there, but damn.... Burns like that would be hard enough for a young person to recover from, let alone a guy in his late 60's.

Anyway, I got to go to the OR and watch some of the surgery. They were putting a trach in as well as finishing up with the exsizing (sp?) of the 3rd degree burns. They weren't even grafting, just peeling, cauterizing, and bandaging. Have any of you ever seen an exsizement surgery? Holy mackerel... It reminded me of filleting a fish. This tool they use looks like a giant potato peeler and they cut the dead skin off in strips. It looks just like filleting a fish.
I watched them peel his leg and i sort of watched them opening his neck up for the trach and that was enough for me. They still had to do his entire left flank and arm. The leg was more than enough for me. I bowed out, went back upstairs to the unit, changed back into my clothes (First thing they did when I walked in was to get me a pair of scrubs and told me to change into them), and left.

I got my respiratory time done, which was pretty boring. I learned a few things about respiratory, watched some of the PT routines, medical treatments, lung sounds, etc.

This past week has been insane. On Thursday, I drove one of 6 buses to Niagara Falls Canada and Marine Land. It was the yearly field trip for one of the grades at school.
I had a blast! I had never been to Canada, Niagara Falls, or Marine Land before Thursday. I took full advantage of being there, too. We went to the Falls first. Once we dropped everyone off, we parked the buses, rode the Peoplemover back to the Falls. I walked along the observation area checking out the falls. I was so pissed that I forgot my camera. I snapped a few shots with my cell phone, but that was it. Anyway, I wandered around the shop and stuff for a while... I almost bought a RCMP hat, but didn't really have the money to spend on it. After that, I went down behind the falls, then we went on the Maid of the Mist. THAT was great. That right there was worth the whole trip.

After the Mist, i beat feet back for the bus, met up with the other drivers, picked up the kids, and off we went to Marine Land. I didn't realize the Falls and Marine Land were so close! Their entrances are right across from each other. Once we got to Marine Land I watched the Dolphin/sea lion show, played the Indycar game in the arcade (that was pretty cool) then just started wandering around. I had heard there was a pretty good roller coaster up there, but i couldn't see it or anything. I checked a few different things out as i was walking along, and I ran into a few kids i know from various bus routes i've driven. They told me "you have GOT to ride that roller coaster, it's freakin awesome!" They pointed me in the right direction and i started that way. I still couldn't see the RC, but i could hear it... Once i got closer, i heard the sound of the R.C. train, looked over, and saw the top of a loop through the trees. I got a little closer and I saw the track, down in a gully like 4 feet off the ground in the woods. I was getting more and more excited because this thing was really starting to look bad-ass.
Sure enough, it was. I went into the tunnel entrance (which is shaped to look like a dragon's mouth), and it was seriously dark in there. Once i got in a little way, i had to actually put my hands out to keep from running into anything, it was that dark. I wound up riding that roller coaster about 7 times in a row with a bunch of the kids. I wish i had found it earlier, i would have ridden it at least 10-15 times. It was great. Quite a few surprises and unexpected twists and turns on that ride.

I get to take another busload of kids to 6 Flags in about 2 weeks, so i'll get to ride the Mind Eraser again. I LOVE that ride. The Superman is great too, but i heard it is closed. The Predator is ok, but i'm not a huge fan of wood coasters. The Predator is so rough it feels like it's knocking your fillings out of your teeth. Especially in the rain. I rode it 3 consecutive times in the rain once and i felt like someone had kicked me in the ribs for the rest of the day.
I think i shall try and save enough money to ride the Sky Coaster when i am there too. That ride is such a rush. They strap you into the harness, hook you to some cables, then pull you up 180'.
When you get to the top, you pull a rip cord which releases you from the winch line, you freefall for about 40', then it turns into a giant swingset. It is a huge rush.

Next summer, I HAVE to get out to Sandusky, Ohio. I've wanted to go to Cedar Point for years now, but have never had the time or money. My brother also wants to go, plus my cousin and her husband live out near there and they already offered us a place to stay. I can't wait. I want to ride those coasters out there sooo bad.

I spent Friday through Monday at the hospital doing ER time, 1100 to 2300 each day. Actually, i did 1200-2300 2 of those days, but whatever. It was pretty interesting for the most part. Alot of run of the mill stuff, a few standouts... I got a bunch of IV's Friday and Saturday. That was cool. Only missed 1 all weekend. I watched the anesthesiologist tube someone in the ICU... I was not impressed with that Dr. He seems like a royal prick and not alot of ppl at the hospital like him.
He did a conscious intubation on this lady and she was not liking it, even though she had asked to be tubed. She's a COPD-er and was having alot of trouble. Once he tubed her you could tell she was fighting it bad... she had the whole red/wild-eyed thing going on. She was freaking out. A day later and she was still fighting it because they didn't have her sedated properly.

By the time Monday rolled around, I was suffering from ER Burnout. I was just sitting around bored, playing Spider Solitaire on one of the nurses computers, talking to my mom and my sister (they were running with QVA and had just brought in a CHF/COPD) when the "Incoming" alarm sounded on the Communications System. The usual ER buzz continued as the Ward Clerk answered the call; in the background I could hear Resource, and they sounded somewhat excited. I couldn't hear what they said, but I found out about 2 seconds later when the ward clerk shouted "Code 99, everybody SHUT UP!" (Code 99 = Full Arrest). Resource patched the responding ambulance through and they proceeded to tell us that they had a 44 y/o male, found unresponsive, pulseless, apneic, CPR in progress and Asystolic on arrival. ACLS protocols in progress, Negative ET tube x 2 attempts, 8 minute ETA.

I asked the Doc if I could have a shot at the tube and she answered with "Not on a 44 year old". Well, Phooey.

Prep the cardiac room, everyone enter stage right, take positions, "Here's the ambulance", press the blue button, hear the famous "Code Blue in the ER" x 3 come over the PA, followed by umpteen sets of tones as the switchboard notified the Resp. Tech's, supervisors, and whoever else they hit. That was kind of a waste of time and breath though due to the fact that we had 10 ppl standing around waiting for the guy.
The ambulance brought him in, transferred him to the bed, I took the compressions position and got thumping. I figured if i couldn't tube, may as well put my muscle to use. The nurses have their own system of administering drugs, so i'd just be in their way. The girl who's job it was to do CPR did not really want to do it. She said that if i wanted to, it was fine by her. She told me later that this was only her 2nd code and she'd never done real CPR and didn't really want to. Maybe I should have let her do CPR, maybe not. All I know is that once I get in my groove, i'm all set for a while.

This guy was a mess. Distended abdomen, puke filled airway, etc. The doc tried to tube him with no success. I guess his throat was swollen pretty bad or whatever. Add a mounting air pressure in the stomach and this guy was really getting messy. He was chunkin up this reddish nasty crap that looked like half-digested blood and smelled like a heavily sauced pasta salad. I said that to one of the nurses and she got totally grossed out. It was kinda funny, in the usual twisted code humor kind of way.
Eventually, the anesthesiologist showed up and dropped the tube (the same ding-dong from ICU a day or 2 earlier). He made it look way too easy and was a total prick about it to the doc and other ppl in the room. He also tossed the laryngoscope onto the guy's chest or stomach and in the process smeared the very messy laryngoscope right across my wrists just above my gloves. I was not happy. It coulda been worse though. some of the nurses and the ER doc at the guy's head got splattered with chunks a few times... better them than me i guess.

Going back a little bit, as soon as we got the guy on the bed I looked at his eyes and knew this was most definately an FPO. He had the classic death stare. You know, eyes wide open, staring straight ahead, pupils blown with that milky glaze... he was gone.

We had been working him for about 40, 45 minutes when they let his wife into the room. I was doing compressions, saw the door open out of the corner of my eye, looked over, and in walks a nurse with her arm around the guys wife. I was thinking "Oh, WTF. She doesn't need to see this." looking back though, maybe it's a good thing... I guess it probably helps with the whole closure process, seeing with your own eyes that everything possible is being done. So we continued working him while she sat at his head, sobbing, kissing his forehead, begging him to come back and not leave her and all that stuff... That was kind of hard to watch. After a few minutes, the nurse leaned down and quietly told her that he'd been down for so long, IF he came back, he'd have massive brain and organ damage, etc... The lady asked him not to leave a few more times, then said "Stop... Stop! Please, just stop!" And that was that. DC the bag from the tube, stop compressions, silence the monitor, wash up, go outside.

I felt really bad for her. We all know the chances when you've been down for a while. By the time the wife told us to stop, he'd been down at least an hour and a half. Figure however long he'd been down before she found him, she called 911 and did CPR for 15 minutes til the ambulance got there, they called the hospital with an 8 min eta, so i can only assume they had him for at least 10-15 minutes prior to calling the hospital, then we worked him for 48 minutes, i think it was.

She was really blaming herself bad. For not finding him sooner, for not making him go to the doctor earlier... He had his gallbladder removed about a week earlier, had fallen a few days before the code and said he felt something rip inside, but didn't bother going to get checked out.
There was some other stuff going on that we found out after the fact... the guy pretty much had a death wish.

A few of the nurses took the whole thing kinda hard... mainly the wife's reaction. It was weird...
I've dealt with plenty of family on codes before, but this was really different and i can't totally place why.

Anyway, that was my weekend.

Then yesterday I brought my car to the shop because my power steering bit the dust the other day. I was hoping it wasn't the Rack, but I figured it probably was, cuz Taurus's are notorious for blowing the Rack and Pinion.
Sure enough, the mechanic looked over the car, fiddled with it for a few, then came and got me. He told me that it was the rack, I was looking at about $500 to replace it, but that i could drive it in the meantime as long as i kept fluid in the system so the power steering pump wouldn't fry. Then he said they were gonna wrap up, that they were trying to get some steering back, etc etc... I went back in the waiting area and 5 minutes later, the mechanic was calling me again. I walked back and he said "We got a problem." Right then, I smelled burning power steering fluid and thought "This is not good." We walked around the corner and I saw power steering fluid everywhere. all over the floor, all over my car... and all over the other mechanic who was standing there with a shop towel trying to clean the power steering fluid off of his glasses. Apparently the defective boot/seal on the rack decided to explode right then. So my car is parked until i can get the money to get it fixed, which i hope is soon. I can still sort of drive it, the only problem is that without power steering fluid, the pump will eventually seize, which will in turn snap the belt that runs the whole car.
I love cars.

Well, i gotta run. I sat up all night writing this because I wasn't tired. I've got more to write about, but we'll save that for another day. Cya