Monday, March 14, 2011

Ee ecky thump

My favourite thing in all of medicine is the praecordial thump.  It's a rarely used first response to cardiac arrest which consists of punching the patient vigorously in the chest and seeing what happens.  The reason it's rarely used is that the resuscitation guidelines say you only use it if you have witnessed the patient having the arrest and they are attached to a monitor.  Presumably this is to stop people like me running around the hospital belting the lights out of people who are having a restorative afternoon kip.

So I was in the operating theatre recently, watching them put a tube through the abdominal wall of a patient and into his stomach.  It was being done not under a general anaesthetic, but under some light sedation like you'd have for a colonoscopy along with plenty of local for his tummy.  Halfway through, the patient started to become unresponsive and tachycardic.  The anaesthetist leaned over and gave him a sternal rub.  A sternal rub is a painful grind of the knuckles along the sternum that you'd do to determine if someone is capable of responding to a stimulus.  And then the anaesthetic nurse, who was watching the monitor, said, "VF".

VF.  Ventricular fibrillation.  Cardiac arrest.  Witnessed.  Monitored.  I wound up my arm to deliver the praecordial thump. I filled my lungs to give the great kiai to project my life-saving Qi into the patient's heart.  I anchored my feet, bracing my hips to the earth so as not to be driven back through the wall of the theatre by the concussion.  "Hyyyyyyyaaaaaaa......"

And the anaesthetist calmly said, "Nah it's just an artifact from me jiggling the ECG dots on his chest."  And sure enough he was fine.

Damn it.


Lumpage said...

I've always wanted to see 'Qi' used in a sentence and not just cheaply on a scrabble board. Kudos.

PTR said...

Your comment made me realise that:
(a) I shouldn't have capitalised qi,
(b) You should have capitalised Scrabble.

So maybe just one kudo each.

JdR said...

So you would've gone all Miss Piggy and suddenly been in an episode of Veterinarian's Hospital ... the continuing story of a quack who's gone to the dogs ...

PTR said...

bwahah - yes, exactly