Yesterday was just a rough damn day!

Lets not focus on the fact that I was very busy for my whole 12 hour shift.  And we’ll pretend not to care that there were some pushy nurses making rude phone calls to find out if I was going to scan their patients or not.  We’ll just skip right to the best part.

Around 4:00, I had to bring a patient down to do a “Thorocentsis”  (Also incorrectly spelled Thoracentesis.)  She was nearly 300 pounds, but her entire left lung space was filled with fluid.  The word “Thorocentesis” by definition means “To puncture the chest cavity.”  More specifically, it means to place a small catheter (or rubber tube) into the space around the lungs (the “pleural cavity”) and drain out any fluid that might be present.  This is different, however, from fluid WITHIN the lungs, which is “Pneumonia.”

It really is quite a simple process.  I use ultrasound to determine an adequate fluid pocket.  The physician, usually a radiologist, comes in and begins a sterile field, and uses numbing medication to numb the area.  He or she then uses a small “trochanter” – really just a needle with a rubber catheter laid over top of it – to puncture into the chest cavity.  The area, we know, is clear of lung or any other organ, because of the ultrasound guidance.  The catheter is hooked up to a rubber IV tube, and that is then inserted into a vaccuum sealed bottle, which then pulls out all of the fluid.  It is, frankly, amazing.

When the fluid stops running, the catheter is removed gently, and a bandaid is placed over the insert site.  There is usually very little bleeding, and a very minor chance of complications.

Today, the procedure went well, as normal.   We removed over 1200mL of fluid for the patient’s left pleural space, and then had to give her a chest X-ray to be sure her lung re-inflated as it was supposed to.  While moving her in the bed to do a portable chest X-ray (remember… she’s 300 lbs), we had to slide her up towards the head of the bed.

The bed was locked, we grabbed the draw-sheet, and we pulled.  However, we didn’t end up moving the patient… instead, the entire stretcher slid forward, right up on to my right big toe.  I can honestly not remember pain so severe.  I instantly started the hopping-crying-dance.   And the poor patient, bless her heart, felt guilty as though it was her fault! 

Nothing broken, and I’m fine, but yesterday was just a rough, rough day.