D is for Defibrillation

OK, Cards (cardiology) is not so bad. Yesterday I was first to a code in the Cardiac ICU. Two nurses in the room and me, quickly followed by my intern. “What’s going on?” I asked looking quickly from the patient to the monitor. “She’s in V-Fib,” the nurses said. Look at monitor & confirm V-fib. Look at patient and confirm unresponsive and lack of a pulse. “Charge the defibrillator paddles and shock as soon as they’re ready,” I ordered loudly and authoritatively. 200 joules only takes a few seconds to charge, and an underwhelming electric “click” produces massive muscle contractions in the patient. Look at the monitor again…asystole…sinus rhythm. Pulse? Check. Patient? Awake. Responsive? Check. By this time, lots more people were in the room including her heart surgeon. I turned care over to him. Another life saved! I like this job. Sometimes.

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