Like an Angel

Sometimes, one happens to be the right person, at the right place, at the right time. I was sitting in the nerve center of the department.  There is a large screen there that displays the monitors in all the OR's.  In addition, there are visual alarms that alert the viewer to a problem in a particular room.  The only person who is there all the time is the secretary who has no medical training whatsoever.  It is not clear, therefore, for whom the screen was installed.

I was ruminating when I noticed a decrease in oxygen saturation in room number 4.  A few seconds later the oxygenation rose up to a normal level.  This in itself is not extraordinary.  Often, during induction of anesthesia, despite preoxygenation, there is a drop and then a rise after the endotracheal tube is inserted and the patient ventilated.  However, a few seconds later, the oxygen again dropped.  Since I was not busy, I decided to go to room 4 to see if they needed help.

I was right. It was a difficult intubation.  There was a young resident and an attending, who happened to be the same attending (aka the teacher's pet) from the infamous incident. We successfully intubated however the patient was very spastic, I deepened the anesthesia, added a bronchodilator and some steroids and the situation improved.

Once everything was under control, the teacher's pet turned to me and said, "You decended upon us like an angel.  How did you know we were in trouble?"

I smiled and said, "I know everything that occurs in the OR, and I sensed that you needed help."

Her jaw dropped in astonishment.  I quickly added that I had seen the drop in oxygenation on the screen and decided to see if I could be of assistance.  

She smiled and thanked me.