So today using my powers of amazing dodge-ability, I managed (by mere milliseconds) to get out of the path of a power-vomit. Not just any power vomit, this was the kind experienced only by those who have joined the ranks of the bowel-obstruction team.
As any emergency nurse would know, this normally entails such copious amounts of vomit that you begin to feel quite amazed and surprised that someone could actually fit that much in. It also smells and looks fecally, and has amazing projectile properties (all adding to the ‘excitement’, of course).
Anyway, using my amazing powers I dodged that sucker in a move that would make matrix fans proud! However, the next ten minutes happened so quickly that it left us looking around at each other saying “did that actually just happen?”.
Basically a guy came in with vomit all over the place and a big distended abdomen. Rolling over to one side caused more vomiting, and rolling to the other to change the sheets / do a PR exam caused even more. And more. Followed by… more.
Bear in mind this all happened within a very small space of time. While we were suctioning etc he suddenly went rigid, and looked like he was fitting. His eyes deviated to the left briefly, and he started going a greyish colour. Which soon turned to blue.
Hold up, he’s not breathing – yet fecal fluid continued streaming from his mouth and nose.
Tough situation – is he coughing up muck with the intention to gasp at the air again anytime soon? Do we keep suctioning till the cows come home?
Airway comes first, and it turns out he didn’t try breathing again – suctioning as much as we could, we then started manually bagging him with an air-viva, until he started some shallow respirations of his own after a minute or two. Pretty soon he was sedated, anaesthetised, intubated, IDC’d, art-lined and very unwell. More lines, more drugs, more consults. Medical, surgical, intensive care.. Antibiotics, fluid I/O, suctioning. The blood pressure juggling act….
It’s funny how things can turn so quickly – one minute it was a regular bowel obstruction patient with that special kind of vomit, the next – well it was kind of surreal…
Anyway – my colleague was not so fortunate and managed to wear some of the blood/vomit on her clothes, which is always slightly sickening to the person it happens to, and slightly amusing to the rest of the staff!
I guess you’d chalk this up to a fairly typical day in the world of emergency nursing…..