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Wednesday, November 24, 2010

A Donut?

I got called to a patient's room the other night by a nurse who was in a complete panic. So I go. I walk in the room to see 4 nurses surrounding the patient's bed, and immediately hear the sound. Not a wheeze or a crackle. Nope, this sounded like a foreign body obstruction. Stridorous. Horrible. All of the people in the room look like deer caught in headlights. And I instantly take in my surroundings. The room literally looks like a wasteland of half-eaten food. Cookies, a pastry, cups of Jell-o, pudding, applesauce. The one nurse is grasping a suction catheter, which I take from her while asking what the patient had eaten and when. And it went like this:
"Eaten??? Nothing! She's NPO!"
NPO, to you laypeople, is Non pour os: Nothing by mouth. Meaning she isn't allowed to eat. But I can smell bullshit a mile away, and her nurse gets very, very defensive suddenly. So I do my business with the suction catheter, threading it through her left nare and into her throat. Down the hatch I go while asking again. One more chance to 'fess up, but nobody bites. And then I start suctioning food out of her airway that looks, strangely enough, identical to the half-eaten donut on her bedside table.
Mind you, I have suctioned some gross stuff out of people. A whole green bean. A macaroni elbow. Vomit. The worst was shit--literally--from a patient with a fistula between the airway and GI tract. But a donut? With the powdered sugar still intact? Seriously? Of course the nurse was still denying that the patient ate anything, even with the evidence right under our noses.
Until we got the patient to MICU and, upon intubation, found the rest of the donut, the donut's wrapper, and for extra fun, a wadded up tissue In her fricken trachea. But she didn't eat anything.
Only in my line of work...
Speaking of weird airway discoveries: this is why they ask you if you have dentures before surgery/ intubation. And you should learn fom this poor schmuck and tell the truth! (Side note: yep, this was at my hospital. Not on my shift, thank God! A coworker removed the identifying info from the image so there is NO infringement on the patient's right to privacy!)

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