- Joined
- Apr 12, 2007
- Messages
- 593
- Reaction score
- 174
ON call last night get the call I dream of, ruptured AAA coming to the OR. Run into Vascular surgeon, 60 something year old,review CT scan with him and it shows 11cm suprarenal AAA with rupture. Patient arrives in OR, quick hx reveals she doesnt see doctor regularly, she is barley responsive. Move to OR table, nurses prep belly, surgeon scrubbed and ready as I place left SC MAC cordis, CRNA puts in R radial aline and BP reads 45/20. Uncrossed PRBC flying in. Drapes up, small dose of versed, 100mg zemuron, Tube in easily, surgeon in belly immediately, BP drops to nothing, 50MCG epi, vasopressin chasers, Supraceliac clamp is on and bp up to 160 nicely, start NITRO drip and crank the gas. HCT 10 and pH 7.1 on first gas. VFIB then ensues x2 with ultimate successful cardioversions. I place TEE probe and see good function with no RWMA's valves all are good, no LV overdistention from high cross clamp. Float PA cath, Resuscitation in the usual manner for 3 hours, patient leaves OR with normal ABG no base excess, nl elctrolytes and HCT 30, INR 1.1. Post op requires diuresis for oxygenation and high filling pressures.
This is why is went into anesthesia. Love what you do and you wont work a day in your life!!!
This is why is went into anesthesia. Love what you do and you wont work a day in your life!!!