April 3, 2012

First off, tonight is kicking my butt as far as not having any sleep and just being worn down, but I have learned a lot tonight. When I first got here, a trauma came into the ER which was a man who had been kicked in the abdomen by a horse, then proceeded to drive himself to the hospital. On the way to the hospital, the doctors believed that he passed out resulting in him driving off the side of the road and into a ditch. When he arrived by ambulance to the ER, his blood pressure was very low and they believed he had ruptured his spleen causing internal bleeding. I noticed that his skin was very gray looking and he was slightly shaking due to being in shock. After the doctors took a look at his ct scan, they decided to take him straight into the OR to remove his spleen (splenectomy), control the bleeding and look at a possible liver laceration. He had lost a lot of blood but they used an Auto Transfusion Device during surgery which took the blood from his abdomen and recycled it back into his body. Once the surgery was completed, I noticed he was talking and had color back to his skin. He was recovering very well.

About the spleen:

The spleen is located in the upper left quadrant under the ribs. There are different reasons for a splenectomy but in this case the patient had ruptured his spleen due to a blunt abdominal trauma which is common. Hypotension from hemorrhage is the most common presenting finding. (http://www.madsci.com/manu/trau_abd.htm)

A man with a blood alcohol level four times the legal limit came into the ER after falling down a few stairs and having his teeth go completely through his lower lip. Due to the severity of the laceration, he received five stitches on the inside of his mouth, four in the middle of the cut to help close it up, then fourteen on the outside of the cut to completely close the laceration. There was a good amount of blood but what made me kind of cringe was being able to see the fat on the inside of his lip, it is not a very pretty sight. But even with the open laceration and blood, I watched the careful procedure of sewing this guys lip back up and attempting to leave a minimal scar once healed.

At about four this morning a Rapid Response was called for a man who still had a pulse, but whose blood pressure was very low. When I got to the room many nurses were already pumping fluids into him, checking his heart and blood pressure. The decision was made to give him a medication that immediately reverses the effects of narcotics in the body, which makes the patient alert and sometimes agitated. His blood pressure began to increase to a safe level and the Rapid Response was stopped.

Below is a list of medical terms that I heard tonight and needed to do further research to fully understand what they mean. From this experience so far, I know that I need to take a medical terminology class ASAP!  

Medical terminology and definitions:

Source of definitions: www.dictionary.com

Pancytopenia (pan·cy·to·pe·ni·a): A pronounced reduction in all of the formed elements of the blood.

Hemoperitoneum (he·mo·per·i·to·ne·um): Blood in the peritoneal cavity.

Hematuria (hee-muh-toor-ee-uh): The presence of blood in the urine.

Thrombocytosis (throm·bo·cy·to·sis): An increase in the number of platelets in the blood. Also called thrombocythemia .

Thrombocytopenia (throm·bo·cy·to·pe·ni·a): A decrease in the number of blood platelets.

Peritoneum (per·i·to·ne·um): the serous membrane lining the abdominal cavity and investing its viscera.

Leucocytosis (loo-koh-sahy-toh-sis): a gross increase in the number of white blood cells in the blood, usually as a response to an infection

Pancreatitis (pan-kree-uh-tahy-tis): Inflammation of the pancreas.

Dysarthria (dis-ahr-three-uh): difficulty controlling muscles of tongue or mouth.

Dysphagia (dis-fey-juh): Difficulty swallowing.

Odynophagia (o-dyn·o-ha-gia): Severe pain on swallowing.

Volvulus (vol-vyuh-luhs): A torsion or twisting of the intestine, causing a intestinal obstruction.

Stenosis (sti-noh-sis): A narrowing or stricture of a passage or vessel.

Bradycardia (brad-i-kahr-dee-uh): A slow heartbeat rate, usually less than 60 beats per minute.

Tachycardia (tak-i-kahr-dee-uh): Excessively rapid heart rate.

Tachypnea (tak-ip-nee-uh): Excessively rapid respiration.