Today was hard. In our school we have this awesome robot that we use to practice emergency medicine. The robot can be programmed to have heart/lung sounds, a pulse, respond to any medications, oxygen or CPR that you give it. It can speak, it’s pupils react to light…it’s pretty much amazing. Anyways today we had a robotics case that was really hectic. She presented with hyperkalemia & hyperglycemia as a complication of missed dialysis (CKD) and diabetes. She was asystole within minutes and on top of that her husband and daughter came into the room while we were trying to intubate. We had to give her CPR which took a while to get into the groove of for us. I was in charge of meds so we gave her IV CaCl, IV bicarb, IV saline, epi and insulin. A group member tried to intubate her once her pulse came back but it was so difficult that it took about 4 tries and 3 people (including me) until she was intubated. At the end of the practical, I was sweating, my face was red and my heart was pumping. I felt defeated, even though the patient did not die and I felt embarrassed in front of the patient’s family. And this was over a robot! The whole way home I was thinking about what we did wrong and how unorganized we were. Was I supposed to give her different meds? Did I intubate her the wrong way? It was definitely not my best performance and I found myself being very lost a lot of the time (and the whole scene lasted only 20 min).
Then I thought I have to work HARD. I have to know my meds so that when it’s a real patient on the table, I know what to give to save her. I have to know how to perform procedures like CPR and intubation like it’s second nature. I have to practice with EVERY chance I can get once I get into the hospitals. This is critical! Not for my life, for real human beings’ lives. And I felt the weight of responsibility that is put on physicians, in particular critical care physicians. I’m not sure if I can actually handle it as a lifelong profession but there will be a time when I need to become so intimate in emergency settings because it’s hectic! and everyone is relying on you to know what to do. So I’ve GOT to learn everything I can. Hopefully when I’m actually in that position I will confidently execute what I need to and not hide in the crowd like I’m so comfortable doing.