# Aw BOOGERS! Tales from the Crash Cart!



## mycrofft (Dec 6, 2008)

Last week one of our inpatient inmates' serum glucose took a dive. Fingerstick 23, diaphoretic, obtunded. Hx of slow response to tx. One nurse gave him a little glucose sludge but he drooled it. Next the nurse shows up with a glucagon syringe and hits him with it. FS to 38, no change clinically. FNP shows up, so I suggest to him "How about we start an IV and give him some D50 bolus stat?". Aha, light bulbs flicker on, three poeple get in each others' way while I get the D50. I come back with it as they are taping the IV in place.
"Is it patent?" I ask.
Nurse looks at taped IV catheter. "Yes".
"Can you see the flow rate?".
She looks up. "No. Turn it on". <_< I turn it on. No drip. Not patent.
Nurse says "Give him the D50".
Mycrofft: "Not 'til it's patent". 
Re-enact cluster booger and start a nice solid 18ga in right arm. Good flow. Mycroft pops open the box of D50....which has no sharp on the Bristoject, just a Luer coupling. Mycrofft snags 16ga needle, does his "Johnny and Roy" imitation popping off the Bristoject caps simultaneously, assembles the contraption,sticks it into the injection port...and goes to inject it...
Exam glove lubricant makes injector so slippery Mycofft's gotta hold the thing with two hands and use his thumbs to push the vial plunger home.
Soooo "swa-vay".:blush:

PS: pt FS glucose shot up to 232, IV DC, pt rapidly recovered...and was released two hours later!!!


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## MMiz (Dec 7, 2008)

> PS: pt FS glucose shot up to 232, IV DC, pt rapidly recovered...and was *released* two hours later!!!



I guess the key to getting released from prison is having a diabetic episode


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## WuLabsWuTecH (Dec 7, 2008)

MMiz - my exact thought!  Wow its easy to get out of prison these days!


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## mycrofft (Dec 7, 2008)

*Hrrumph..."Jail", if you please!*

Prison workers get way more money and earn it.

No, his sentence was up. We'd been through this with him about seven times, willfully noncompliant and a few more brain cells gone each time.


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## Airwaygoddess (Dec 7, 2008)

*Now that is what I am talking about!!!*

yea my croft for a great catch and going "johnny and roy"!!!!!!!!!!!  B)b)


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## RESQ_5_1 (Dec 7, 2008)

The luer-lock tip is one of the reasons we use saline locks on our field IV starts. And, at least you had the presence of mind to check for a patent line. Well done. My partner had a recent diabetic pt but was unable to get anything larger than a 20 into the pt. Took forever to get 1/2 the D50 into him.


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## mycrofft (Dec 9, 2008)

*Just gimme a nice honest rubber needle port!*

A co-worker gave D50 straight into the vein from the Bristoject twice. First time, worked. Second time went into bicep, over tenK$ to repair it and rehab. Different pt, and that coworker became a supervisor. (Safer I guess).
Yeah, my forte is when the routine goes screwy, I'm the one who pops up with the magic ingredient or cuts the Gordian knot.

Maybe they will give me some time to put on mini-exercises now?!<_<


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