How many pts have expired on your table?

[urge]

---

Members do not see this ad.

3 for me. What's your count?

 

[camkiss]

Chief resident at a major trauma center with active gun and knife club.
Only 1 died on the table under my watch. I feel pretty lucky.

 

[VentdependenT]

one. 6o liter blood loss liver

 

[militarymd]

2 that I remember in the OR...

Countless in the ICU.

 

[zippy2u]

Zero! Looks bad if they die on the table, slick. All that matters is what's showin' up on the ecg monitor. I have thrown em over in the ICU paced with the gain maxed out, twitchin' all ta hell --ain't dead yet-- got a HR of 60-- see look at the screen, Mr. surgeon. Don't worry too much about the pulse--it's faint and ya need a doppler and we ain't got no time to monkey around with a doppler. See, the ICU man pronounces the pt's dead and it's on his turf. Less headaches for you. Regards, ---Zippy

 

[Planktonmd]

People do die and they do it everywhere including the OR.
I had 5 or 6 people who died on the table despite all my efforts and each single time it sucked tremendously.

 

[nvshelat]

The surgeon tells the family, right?

 

[Planktonmd]

The surgeon tells the family, right?

I always talk to the family with the surgeon in these situations.
They might have questions that the surgeon can not or should not answer and it's usually helpful for them to see the physician who took care of their loved one at his/her final moments and to hear him say that everything possible was done to avoid this outcome.

 

[Frank Rizzo]

Two:

#1 was a ruptured AAA from an outside hospital that arrived to me in the OR with a rapid transfuser running, and ACLS on going. We basically did an autopsy under GA, but flogged him for 45min cuz was only 45 yo

#2 a knife and gun club victim that had been shot x4 (2 in abd, 2 in chest) with an AR-15. Damage control surg attempted... didn't work so well.

 

[Fooper]

I've lost 5-10 over the past 14 years, all but a couple during hearts/major traumas/ruptured AAAs. In fact, I'm really happy about not currently doing hearts because it's just eerie to be the last person on earth to look into the eyes of a patient you can't get off pump.

One that sticks out was a dialysis patient under MAC that went flat line and was unresuscitatable after the surgeon lacerated his sublclavian artery trying to put in a dialysis line. He dumped his entire blood volume into his chest in a matter of seconds. He was supposed to be an outpatient too -- what a bummer that was!

 

[Planktonmd]

One that sticks out was a dialysis patient under MAC that went flat line and was unresuscitatable after the surgeon lacerated his sublclavian artery trying to put in a dialysis line. He dumped his entire blood volume into his chest in a matter of seconds. He was supposed to be an outpatient too -- what a bummer that was!

I had the exact same case 5 years ago and I still remeber that poor old woman and the conversation we had preop: she asked me to take good care of her and I promised her to do that.
We didn't!

 

[Ferdie]

One that sticks out was a dialysis patient under MAC that went flat line and was unresuscitatable after the surgeon lacerated his sublclavian artery trying to put in a dialysis line. He dumped his entire blood volume into his chest in a matter of seconds. He was supposed to be an outpatient too -- what a bummer that was!

DAMN! There really is no such thing as a minor procedure...

 

[Mozart45]

Zero! Looks bad if they die on the table, slick. All that matters is what's showin' up on the ecg monitor. I have thrown em over in the ICU paced with the gain maxed out, twitchin' all ta hell --ain't dead yet-- got a HR of 60-- see look at the screen, Mr. surgeon. Don't worry too much about the pulse--it's faint and ya need a doppler and we ain't got no time to monkey around with a doppler. See, the ICU man pronounces the pt's dead and it's on his turf. Less headaches for you. Regards, ---Zippy

I start med school in the fall and am currently an ICU nurse. In our unit we usually continue ACLS for at least thirty minutes when we receive a pt like this from our OR. I work in a large transplant facility and sometimes things don't turn out so well, but technically they made it out of the OR. Glad I won't have the job of talking to the family with the docs in these situations anymore.

 

[jetproppilot]

I had the exact same case 5 years ago and I still remeber that poor old woman and the conversation we had preop: she asked me to take good care of her and I promised her to do that.
We didn't!

Same thing a cuppla weeks ago except it was a port for chemo on a robust 70 year old lay....sheath tore the innominate and SVC.

Had same preop conversation with her and 5 of her 7 kids.

Easy, light MAC anesthetic.

Terrible, cogent, unsuccessful resuscitation.

Bummer.

 

[Ferdie]

So, when you lose a patient, do you go on and finish the rest of your day and do the next case, because someone has to? Or does someone else cover your room so you can collect yourself somewhat?
Sure, I suppose the longer you're in medicine, the more people die whose care you were involved in, regardless of if it was on your table, 15 minutes after you dropped them off in the unit, or a week later on the floor. Maybe it's just because I haven't been in medicine that long yet, but I just feel like I might have a tough time being 100% focused during my next case...

 

[urge]

So, when you lose a patient, do you go on and finish the rest of your day and do the next case, because someone has to? Or does someone else cover your room so you can collect yourself somewhat?
Sure, I suppose the longer you're in medicine, the more people die whose care you were involved in, regardless of if it was on your table, 15 minutes after you dropped them off in the unit, or a week later on the floor. Maybe it's just because I haven't been in medicine that long yet, but I just feel like I might have a tough time being 100% focused during my next case...

Depends on how much of a pansy your are.

If you are affected to the point you cannot concentrate, you should be relieved. You should get a pay cut too for being a pansy. I mean, putting extra work on your partners.

 

[Ferdie]

yeah, guess I'm a "pansy," whatever... Haven't had a whole lot of people kick it in front of me, thank god, and I think it would really upset me at least for the first time or two, or maybe just if the patient was extra nice and it was that time of month and a full moon the day before and I was having a bad hair day, how the hell do I know. At whatever rate, I think that makes me still human, and I'm cool with that, thanks.

 

[lvspro]

Same thing a cuppla weeks ago except it was a port for chemo on a robust 70 year old lay....sheath tore the innominate and SVC.

Had same preop conversation with her and 5 of her 7 kids.

Easy, light MAC anesthetic.

Terrible, cogent, unsuccessful resuscitation.

Bummer.

We had one of these at our institution not too long ago... friggin guy lived b/c of our fast thinking.

SRNA sees the drop in bp, tubes pt, calls for help. Surgeon standing there going "wtf is going on!!??" Attending arrives, sees PEA, dx a tamponade lickity split, calls for her buddy CV surgeon to the room stat. He gets there opens, fixes, to ICU, lucky SOB lived w/o sequelae 😱

 

[Ferdie]

We had one of these at our institution not too long ago... friggin guy lived b/c of our fast thinking.

SRNA sees the drop in bp, tubes pt, calls for help. Surgeon standing there going "wtf is going on!!??" Attending arrives, sees PEA, dx a tamponade lickity split, calls for her buddy CV surgeon to the room stat. He gets there opens, fixes, to ICU, lucky SOB lived w/o sequelae 😱

all in a day's work 🙂
was an SRNA in the room alone?