Today I had a lovely pt. on contact precautions for MRSA colonization (no active infection), and got to follow her to the lab where they were testing her brand new internal defibrillator. What this involves is quite nerve-wracking. They sedate the patient, pace her on the T-wave, which sends her into V-fib, and then WAIT and see if the defibrillator can kick her back out of it into sinus. This was the SECOND test. The day before the test had failed, and they had to use the external paddles. This time, after ten heart-stopping seconds, she cardioverted, and all was well.
The second drama in the day unfolded about 4 minutes after I left the lab: one of my classmates came running up to say that a girl in my carpool had collapsed in the hallway, unconsious, and was being taken to the ER. Needless to say, the two of us in the carpool with her ran down to the ER, and stayed there until her discharge 4 hours later. Diagnosis? Vaso-vagal syncopy, with mild bump on the head. Basically, she stood still in a freezing room for four hours, and hadn't eaten in 6. When she walked OUT of the cath lab into the hallway, which was VERY warm, and her blood started moving again, she passed out and bumped her head. All is well, but it made for QUITE an exciting day. The best part was taking the EKG electrodes off her every 20 minutes so that she could go to the bathroom, because they had her IV running in so fast.