EM at its finest:
Ending a shift with a bang. [bloodletting.blog-city.com]
I write a nice note trying to capture the essence of what I did and why I did it. Can't write "decided to go big or go home" so I wrap it up in that nice, sterile and intentionally understated medicalese which makes it seem like the decisions were clear cut, and based on solid information, when the truth is that they were largerly judgement calls based upon spotty and/or inaccurate information.I sign out and then I punch out.
In EM we often don’t get to wait for the test result, or for a period of observation. Curse, and beauty, of the job.
…and I was wrong.
The cyanide level came back below detection threshold.
So I burned about $3,000 on an antidote kit that was unnecessary, and also an unnecessary ICU admit. The guy was extubated and discharged within 48 hours.
So, I was wrong.
…but given the same situational uncertainty, I would do it again. After all, had he not been intubated, he might have aspirated and died on the floor, for all we know.