Friday, May 21, 2010

Mother Hen

I've just finished tutoring three rotations of med. students.  As their tutor, I had to decide on the content of the rotation, the schedule, make sure they had scrubs, lockers, food, basically worry about everything except wipe their noses. I felt more like a mother hen than a clinical instructor.  The first and last group were good. The second group made me depressed.  They seemed completely uninterested.  Whenever I asked a question (my style of teaching is very interactive) I was answered with silence and the glassy-eyed gaze of a newborn calf. I asked one of the students, based on her family name if she was related to the CEO of one of the health funds.  She replied that she was his daughter. I thought to myself, "Now I understand how she was accepted into med school."
During their rotations, I'm not assigned any particular schedule, so I help out whenever necessary and do emergency cases. One morning, I heard a call for help on the PA, when the call was repeated I went to that room. I asked the anesthesiologist was was wrong, she said asystole - cardiac arrest.  For some reason, she was drawing up meds and had not started closed heart massage.   I immediately started heart massage, other anesthesiologists came into the room and the incident quickly became a "mass caregiver event" (as opposed to a mass casualty event - which is much easier to manage.) After atropine and adrenaline the patient's pulse returned. And I left the room.
Reflecting on the case, I recalled what I learned in the ACLS instructors course: Recall of course content is very poor, hence requiring recertification at regular intervals. This was certainly true of this case, since the anesthesiologist did not immediately begin heart massage after calling for help.
My suggestion that I give a couple of refresher lectures to the department was accepted by the boss.
P.S. - The patient recovered completely with no neurological or cardiac sequelae.


Anonymous said...

I was answered with silence and the glassy-eyed gaze of a newborn calf.
As a teacher I sympathize!
And I am glad you saved this patient.

Lioness said...

This is what I find scary about being in hospital, there isn't always one you around...

Pesky Settler said...

I've been following your blog and although I rarely comment, I've found it to be fascinating.

I was wondering if you could help me with a question... would you know if there is there a list online of c-section rates (by hospital) in Israel?

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