Pulm: The IJ

This morning I met with Andrea and Dr. Ozzie in the ICU to see our lone ICU patient: a 66-year-old man who developed cardiac arrest and V-fib with a delay in CPR (but he got defibrillated, fortunately). He was intubated but not sedated, and though he reacted to pain, his neurologic signs were somewhat abnormal. Both Babinski reflexes were positive, and his eyes were sluggish and fairly non-reactive to head rotation. He also needed a central line (IJ), so Andrea got to do that while I watched. The ultrasound machine was malfunctioning for a while but Dr. Ozzie refused to do the IJ until it was fixed. This is a far cry from JPS, where central lines are done blind without the aid of an ultrasound, but this patient had a lot of fat around his neck and clavicles so in his case an ultrasound was necessary. Fortunately we got the ultrasound plugged in, but the IJ was still not without its difficulties. The patient was unconscious, but not sedated, so during the procedure he'd sometimes move his arms, legs, and head. I had to slide my hands under the sterile field in order to keep his hand down. It took a few sticks to get the vein, but Andrea got the job done. Better her than me; I've only done subclavian lines.

After work Kate and Amber invited Lisa, Danny, and me to join them for dinner at a restaurant called Bodacious BBQ. The sweet tea there was pretty good, and the five of us chatted about all topics ranging from our pets to our classmates. Then later in the evening Kate knocked on our door and asked if we wanted to play "sucker ball" with them. It's a game where you hold a racket with suction cups on one side and toss a ball back and forth with the goal of catching the ball with the suction cups. It was pretty addictive and Amber and I got pretty good with playing ambidextrously. Lisa came out to play a little later, but it was all a nice bit of fun. Danny didn't come outside at all, despite our laughter; he was probably sleeping.