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A few nights ago, working the night shift. Around 0530 comes in a patient who is truly critically ill - AFib at 180, and status epilepticus. I end up having to induce a phenobarb coma, and intubate, and cardiovert.
When I went to intubate, I passed the tube, and said, "someone listen". There were 3 nurses and an RT in the room. I thought that the nurse closest was experienced. He puts his stethoscope on, and puts it right over the xiphoid. I point a little lower, to the epigastrium. He listens, but doesn't say anything. I say, "well, what do you hear?"
His answer? "Rrr, rrr, rrr"
I am not kidding. The RT put her scope on and listened over the epigastrium and lung fields, and said that breath sounds were present.
Be wary of with whom you are working. What he reported was the sound of the reverb of BVM ventilation. What I did not know was that he has spent all of his off-training time in the CHF (obs) unit.
The staff thought it was funny (after the fact), and one nurse said she went over to another part of the ED just after this, and told the story, and the doc there asked, "Did Dr. Apollyon's head explode?" The more I thought of it, though, I thought it would be embarrassing to the guy, as his was a lay-person evaluation, and not what would be expected of a professional.
When I went to intubate, I passed the tube, and said, "someone listen". There were 3 nurses and an RT in the room. I thought that the nurse closest was experienced. He puts his stethoscope on, and puts it right over the xiphoid. I point a little lower, to the epigastrium. He listens, but doesn't say anything. I say, "well, what do you hear?"
His answer? "Rrr, rrr, rrr"
I am not kidding. The RT put her scope on and listened over the epigastrium and lung fields, and said that breath sounds were present.
Be wary of with whom you are working. What he reported was the sound of the reverb of BVM ventilation. What I did not know was that he has spent all of his off-training time in the CHF (obs) unit.
The staff thought it was funny (after the fact), and one nurse said she went over to another part of the ED just after this, and told the story, and the doc there asked, "Did Dr. Apollyon's head explode?" The more I thought of it, though, I thought it would be embarrassing to the guy, as his was a lay-person evaluation, and not what would be expected of a professional.
