Monday, October 3, 2011

How to convert

This youngish guy comes to the ER complaining of palpitations, and he turns out to be in Afib with a rate of 140-160. We toss the usual meds at him, none of which work. Cardiology is consulted, and they recommend giving him flecainide before sitting on him for 6-8 hours. I go in, explain to the dude what I'm giving and why, and then give him some pillows and blankets and tell him to settle in.

Six hours later, he still hasn't converted from Afib. The doc talks to him, and decides to cardiovert. Why we didn't do this way earlier is beyond me, but whatever. I get him set up, put the sticky pads on, bring in the EKG machine, and make sure the conscious sedation consent is signed by all parties.

Just before starting the sedation, the guy calls me over. He whispers, "Can I use the bathroom? I'm kinda nervous and I really, really need to go." I offer a urinal, and he gives me the sideways eye which translates to I don't need the urinal, I need to go blow the bathroom up. Doc doesn't want him walking without the cardiac monitor, so I set up a bedside commode. We're all loitering in the nursing station, waiting for him to be done, when I look up at the monitor and notice...hey...yep. Sinus rhythm.

How amusing. We do just about everything to get this guy to convert, and all it really took was him dropping a deuce. Oh, the miracles of medicine.

5 comments:

AtYourCervix said...

Could you have tried a vaso-vagal response, like having him bear down, cough, or even rub his carotid? (I'm not a cardiac/ER/ICU nurse!). Wonder if that would have worked, since straining to have a BM did work. LOL

Shrtstormtrooper said...

We tried within the first couple of minutes after he got there, it didn't work though. Sadly.

hoodnurse said...

A friend of mine at work always says that 90 percent of the people in our waiting room would be cured if they just went home and took a giant dump and a nap. I thought this only applied to the non-critical patients, but I guess not.

minimedic said...

So those vagal manuvers really do work...

K-Lynn, RN said...

Love it! A poop a day keeps the doctor away. Screw the apple!