Wednesday, July 4, 2012

In My Patient's Eyes: On the Edge of Code Blue




Last night, or rather, early this morning, I was called to the Intensive Care Unit to intubate a patient. On the phone, the nurse asked me what drugs I wanted for intubation. (I have options). I asked about hyperkalemia, renal failure, stroke, paralysis, all things that would affect my choice of muscle relaxant. And then intuition kicked in: what about blood pressure? Is the patient hemodynamically stable?


Yes.


I come upstairs to see a patient halfway through the dying process. There was a chest tube, elevated intracranial pressure, obtundation, and unresponsiveness. The vitals technically were stable, stable in the I am fixin' to code on you way. There was no margin for error on the anesthesia in this case--too much and the patient would require chest compressions.

I did an awake look, and passed a tube with no anesthesia, to keep vital signs stable.

But was it in the right place? It may have been in the esophagus (not-so-good) or in the trachea (good). My ways of testing were not as reliable in this patient due to the unstable blood pressure and heart rate, color, and noise in the chest and abdomen with ventilation. I called for waveform end-tidal CO2 capnography, just like we do in the O.R.

As I was waiting, the patient looked me straight in the eye. And instantly I knew--it was in the wrong place. The CO2 detector confirmed it. This is never a problem if it is detected quickly, and corrected at once. Which is what happened.

Energetically, when I walked into the room, I picked up an energetic maelstrom. The energy of the patient was chaotic. And I got a fleeting impression of, 'I want to die!'. But it faded. The entire time I was searching, as I worked with my hands, my spirit was asking 'SOS! SOS!SOS!'.

The patient, in their state of distress, on a soul level, heard. And gave me the answer that I needed. A direct look in the eye, that said, 'help me! something is not right!'

No matter where you are, or how confused you get, know for sure help will arrive; all you have to do is ask for it.


Even to keep somebody from coding.

Namaste,

Reiki Doc

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