Complications

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lymphocyte

lymphocyte

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I won't go into too many details, but I've gone through it my head about a hundred times. I was putting in temporary pacing wires via a femoral approach. Ultrasound guided for the puncture and the fluro for the rest. Cardiologist scrubbed with me. Seemed to go well. Patient ended to with a retroperitoneal haematoma the next day and almost coded. I feel like dog **** 😞. I've put in I dunno how many femoral lines and about 20 temporary pacing wires with no real complications until now.

Our director put his hand on my shoulders and said, "intensive care is a contact sport." He left it at that. ****.
 
lymphocyte said:
I won't go into too many details, but I've gone through it my head about a hundred times. I was putting in temporary pacing wires via a femoral approach. Ultrasound guided for the puncture and the fluro for the rest. Cardiologist scrubbed with me. Seemed to go well. Patient ended to with a retroperitoneal haematoma the next day and almost coded. I feel like dog **** 😞. I've put in I dunno how many femoral lines and about 20 temporary pacing wires with no real complications until now.

Our director put his hand on my shoulders and said, "intensive care is a contact sport." He left it at that. ****.
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Sorry to hear that happened to you. But **** happens. I was putting a chest tube on a COVID patient last month and as soon as I inserted, there was massive bleeding through the tube. Chest tube looked like an ECMO cannula. It was on the right side so I don’t think I was in the heart. Don’t know what happened. I did massive transfusion, performed good CPR . But patient bled to death. It was ****ing horrible. I had to put a chest tube in that same room again earlier this week.

I am curious about the circumstances surrounding your situation. I’m assuming you’re CCM? In what situation did you need to put a femoral approach pacer as an intensivist? In the Cath lab? Or fluoro at the bedside?
 
CCM-MD said:
Sorry to hear that happened to you. But **** happens. I was putting a chest tube on a COVID patient last month and as soon as I inserted, there was massive bleeding through the tube. Chest tube looked like an ECMO cannula. It was on the right side so I don’t think I was in the heart. Don’t know what happened. I did massive transfusion, performed good CPR . But patient bled to death. It was ****ing horrible. I had to put a chest tube in that same room again earlier this week.

I am curious about the circumstances surrounding your situation. I’m assuming you’re CCM? In what situation did you need to put a femoral approach pacer as an intensivist? In the Cath lab? Or fluoro at the bedside?
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I appreciate that, thank you.

Still training CCM. Patient had tachy-brady syndrome with recurrent syncope. Needed to go to the mothership for a PPM. Retrieval didn't want to take them without temporary pacing wires, which seemed both reasonable and unnecessary at the same time (we thought they could manage with T/C pacing if needed but also probably not ideal in the sky).

We have a cardiologist who does them via femoral with fluro at the beside. Works really well, and that's how I've learnt. He's a a great mentor and calls me in for these or pericardiocentesis. He was scrubbed in with me.
 
Complications are the price of doing business
 
We cause harm with our MDM not infrequently but the detachment when it's not a procedure is just easier to disconnect from. The obvious and irrefutable connection to the complication when it's from a procedure is burdensome. Just hits way harder. Respect to surgeons and proceduralists for this. But ultimately **** happens. Retrospect and learn from it if there are lessons to be learned. If there aren't there aren't. But don't let it get in your head too much
 
lymphocyte said:
I won't go into too many details, but I've gone through it my head about a hundred times. I was putting in temporary pacing wires via a femoral approach. Ultrasound guided for the puncture and the fluro for the rest. Cardiologist scrubbed with me. Seemed to go well. Patient ended to with a retroperitoneal haematoma the next day and almost coded. I feel like dog **** 😞. I've put in I dunno how many femoral lines and about 20 temporary pacing wires with no real complications until now.

Our director put his hand on my shoulders and said, "intensive care is a contact sport." He left it at that. ****.
Click to expand...
Anesthesiologist here. Sure you had a complication but that is the price of doing business. Probably poor protoplasm, poor vessels, you know the drill. I know experienced vascular surgeons who have had access screwups as well. When you screw up something that is 100% within your control (a preventable mistake), you need to seriously self-reflect. Not so much this time.
 
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