Clinical encouters they don’t prepare you for in residnecy…

A Lady with pneumonia passes out while nurse is drawing blood. She stops breathing, she’s in vfib. CPR, shock at 200 Joules, she starts breathing again. (That much they prepare you for, it’s the rest of the story that’s unique…)

“I’m choking,” she says when she wakes up. The tech is wrestling with her to try and help the nurse get IV access.

“Your heart stopped,” I tell her.

“YOu should have let me go,” she says as she and the tech continue arm wrestling.

“We had to do CPR and shock your heart to get it beating again,” I explain.

“Well why did you do that? You should have let me go.”

“We didn’t know what you wanted,” I tell her.

By this time we had obtained a 12 lead EKG which explais why she had a cardiac arrest. Her EKG is through the roof and I call the cardiologist to get her straight to the lab.

“You’re having a heart attack,” I explain sternly.

“I don’t care, I’m thirsty.” she says. “Where are my dentures?”

I recall her comments about feeling like she was choking, and I swallow hard. “Did you have them with you when you came in?”

“Of course I did.”

“Did you swallow them?”

She shoves her hand into her throat up to her wrist and pulls her dentures out, only they are hooked into her soft palate. I grab the dentures with forceps, she’s puking on me, I can’t get them out, and she’s choking (and having a heart attack). Just then the cardiologist calls me back as I have my hand in her mouth, puke running down my arm. I had the forceps to my boss and leave him to fish out the dentures.

What a nightmare. FInally the dentures were removed, the cardiologist arrived and off she went to have her heart squirted with dye.

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