Week 6 - Karin

Aside from working on my research project, I shadowed a PA, Laurie Yin, that worked with Dr. Alex Swistel. I observed Laurie's meeting with the patients: going over their medical history, going through what exactly brought the patients there, the patient's physical exam (I also had the opportunity to palpate a breast tumor mass ~3cm in length), and looking through their diagnostic images.

I shadowed the Burn unit with Young-Hye and observed the attending doctor (Dr. Yurt) go through rounds with the residents, PAs, nurses, technicians, and pharmacist to assess the healing and status of these patients (two of which were toddlers). We watched a resident sterilely perform an arterial line replacement (has to be changed weekly) in the patient's room.

I was also in the ER this week, or rather ED, with Dr. Matt O'Neil. The ER was very fast-paced with all types of patients. One patient was in a few severe accidents in the past and had gotten addicted to pain narcotics. The patient was trying to overcome his addiction, but with the anxiety attacks he has (for which he has to take Valium) it has been difficult. He came into the ER because his wife was worried he had overdosed on narcotic and anti-anxiety medication. These medications may have a synergistic effect that could cause respiratory suppression. Additionally, the medications he has may also have Tylenol; if he had an overdose of Tylenol, there is a chance of liver failure.

Another unit I shadowed was MICU. This unit gets a variety of cases (e.g.: patients with respiratory or liver failure, bone marrow transplants, etc.). A 55 year old patient in this unit had gotten orthopaedic surgery and because of the chance of clots that could cause pulmonary embolism, he went down to radiology to get a CT scan. He complained of chest pain and shortness of breath (indications of a heart attack) during his scan, so they brought him back up to MICU. He lost his pulse when his arrived back in MICU, causing most of the unit to congregate to his room to aid in his immediate life-saving care. Nurses and residents took turns compressing his heart and taking his pulse; doctors, nurses, residents, and technicians gave him numerous intravenous injections of sodium bicarbonate and epinephrin. He regained his pulse once, but ultimately passed away.