The Lecture Circuit

    Before I begin to talk about today, I first wanted to finish the chapter on last night. As you recall, Joe, Rob and myself spent a lot of time in the ICU last night trying (unsuccessfully) to save two lives. Some would argue that we put more time into it than we should have, but it's easy to get carried away in the effort. We returned home, I finished the blog update, and went to bed. An hour or so later, Joe got a call about a likely organophosphate poisoning victim in the Casualty Ward (aka ER). Per report, his pulse was barely palpable, he was severely bradycardic, and he wasn't breathing enough. We ran to the ICU, gathered our supplies, and headed to Casualty to sort it out. Joe intubated him immediately upon arrival, and we began a vigorous resuscitation with atropine and dopamine as the cornerstones of our treatment. This was a long night in the ICU sandwiched between two full days in the "Theatre", but I'm pleased to report that, because of our efforts, our patient is nearly completely normal this morning, and thanked us for saving him. We were excited that we did some good for at least one person in the chaos of the evening, but there may have been a component of sleep-deprivation psychosis in that excitement as well.

PURPLE MONKEY DISHWASHERS!!!

    After a (brief) nap at home, we returned to the ICU to check on the patients. Everyone there appeared to be in good shape, and I fiddled a bit with one of local elder ventilators before preparing to give our ICU CME talk on "Airway Management".

Confusing equipment = job security

    Now the topic that we were to be lecturing on was not actually one that we chose, but rather one that had been given to us. Since the basics of airway management can be described in half the time we had available, we spent the first 15 minutes presenting our plan to have a "999 checklist". This would be all the items the ICU nurses should have ready for an emergency situation by the time we arrive after a stat page. As you can imagine, our experience from the previous few calls played into this plan. The talk as a whole was well-received, and we established ourselves as educational powerhouses.

This picture was in no way staged.

    We celebrated our new titles with a trip to the cafeteria before going to the OR, and finally got to feast on some of that delicious Ndazi we have been struggling to acquire.

*heavenly chorus*

    We then turned our attention once again to the systematic evaluation of the student anesthetists and the save delivery of the myriad of patients who would visit the OR during the day. We really took it to the next level today by making a jet-ventilation set-up for one of the students, and by showing a few others the art of the deep extubation.

*For anterior neck use only

"Now the key with the deep extubation is to not completely screw it up."

    After finishing in the OR, we went to the ICU for signout and then headed to a friend's house for a wonderful pizza dinner. We stopped by the hospital afterwards to sort out a difficult bed situation (should we have this much power in the hospital?), and have since returned home. Here's hoping the rest of the call night is uneventful...