Tuesday, 20 November 2007

AAA

Yesterday I worked on a response car as D was on leave and had a good day, well apart from the lack of meal break and the migraine at the end..... I did several chest pain patients, one of which was back pain not chest pain, the other two were unlikely to be having anything significant going on as nothing was showing up on our 12 lead ECG.

The one with back pain was my most interesting job. I got there, walked and thought, oh this may be cardiac, he doesn't look very well. When I asked what the problem was it was back pain not chest pain. I asked a couple of questions about how the pain came on and if he had done any heavy lifting, he said no. He was quite pale and starting to sweat. He had a weak radial pulse on the right but nothing I could feel on the left. At this point I started to get twitchy so I popped him on 100% oxygen and took his blood pressure, which was 80 systolic. I thought, this may be a triple A, abdominal aortic aneurysm, which is a bad thing. When the crew arrived it was an experienced crew and they thought it may be kidney stones or something similar. I mentioned my thoughts to one of the crew and it was left as that. They gave the patient some morphine and popped him up the hospital.

I found out today from the crew that he had been transferred to the JR in Oxford that night for surgery on his AAA and did not look well. Obviously it is good for me to know I made the right diagnosis having never seen it before but I don't think they were expecting my patient to survive and I feel bad that I was right.......

Other than that I got soaked through at an RTC, even my knickers were wet........ I wish people wouldn't crash their cars when its raining (please, please, please....!!).

2 comments:

mdmhvonpa said...

Heh ... don't crash your car when it is raining and slick ... so DEMANDING! :D

Anne said...

Good diagnosis! Isn't it gratifying to know you were right? Each of these experiences make you grow in your profession.

Yes, sad for the patient, but YAYY for you.

Anne