This week I started my emergency medicine month and I am a kid in a freaking candy store.
I’ve loved emergency medicine, or the concept of it, since I was sixteen years old when I first took a lifeguarding class. I did this so that I could spend my summers on staff at jewcamp getting tan instead of shepherding campers around, because I am lazy and vain.
The best part of lifeguard certification was, without a doubt, learning how to use the automated external defibrillator. The AED is a brightly colored box that you hook up to a patient who is maybe having a heart attack. There is a very small elf inside the AED who decides, using elf magic, if shocking the patient with the rough equivalent of enough electricity to jumpstart a Volkswagen will bring them back to life.
Why was learning to use the AED so great? If the machine decides a shock is warranted, it takes a few seconds to charge up, emitting a gloriously dramatic, rising “WHOOOOOOOOOOOOOP” sound, followed by a voice prompt to “STAND CLEAR. SHOCK PATIENT NOW.”
In the middle of the device is an enormous, red, flashing button with a picture of a lightning bolt on it. And now for the best part: you push this button, at which point your patient may or may not spontaneously wake up and scream “I’M ALIIIIIIIIIVE,” Get Him To The Greek-style. Alternatively the patient may or may not transform into Dr. Doom from the Fantastic Four.
(Watch that link.)
Anyway. Thus was born Nate’s Great Love for Emergency Medicine, which is really just a proxy for my love for bright lights, shiny objects, and buttons that do exciting things. This, not incidentally, explains why I enjoy flying (tons of buttons), fireworks, thunderstorms, and Michael Bay movies.*
*Just kidding. No one really enjoys Michael Bay movies.
Why emergency medicine, besides the bright-lights-shiny-objects thing? Well, for starters, there is no rounding. If we ever capture a high-ranking ISIS soldier alive, we should skip the waterboarding and just make him round in a full ICU for a couple of days. He’d give up the entire organization in 72 hours, guaranteed.
There is also the strong possibility that an emergency medicine shift will include Doing Things, which is often not the case on a non-surgical service. The list of Things You Do in the ER is a gloriously long one, and many of the items on said list are bright, shiny or have buttons. You suture lacerations, intubate, drain abscesses (which is gross and weirdly rewarding), and craziest of all, run codes.
A code, to the nonmedical, is basically when a person goes or is about to go into cardiopulmonary arrest – they stop breathing, their heart starts behaving like it dropped too much acid at an Avicii concert or it stops altogether, or the person turns green, rips out of their clothes, and starts destroying the floor.
(Seriously, what is the over/under on the number of Hulk references on this blog? 18? 20?)
This is your classic TV drama “CODE BLUE” where a million people run into the room and there is a great quantity of loud voices and beeping and, yes, buttons.
Part of our EM training this month includes getting certified in ACLS, advanced cardiac life support. In truth, there is very little that is “advanced” about it (insofar as most of it doesn’t work) but the steps are still worth following if they’re the best steps we have for a dying person.
I love ACLS. It combines my aforementioned interests with the additional perk of ordering people to do things, which I also greatly enjoy. I am learning very intelligent-sounding commands to say at maximum volume. For example,
“LET’S GO AHEAD AND GIVE AN AMP OF D-FIFTY.”
“LET’S GIVE CARDIAC EPI 10 CC’S IV PUSH”
…or, my true favorite,
“EVERYONE STAND CLEAR… IT’S CLOBBERIN’ TIME!”**
**I hated Fantastic 4. I don’t know how I ended up quoting it twice in one post.
I made that last one up. Although you could conceivably use that line immediately before performing a precordial thump, which is where you literally slam your fist down onto the patient’s chest. The idea is that you squeeze the heart suddenly, producing an electrical discharge which may disrupt the arrhythmia that is killing the patient.
If that sounds like BS, that’s because it is – it’s extremely unlikely to work. However, just so you can see what it looks like, I went and found this video of literally the worst CPR instruction ever recorded. But there is a pretty good precordial thump at the beginning. Also, it is in Russian. Don’t say I didn’t warn you.
More to come from the weird, exciting, wonderful world of my probable future career.