Keep calm and page anesthesia!

Anesthesia is a pretty social field in medicine.  Even though you can be stuck in a room with no windows for hours on end, one can typically have good conversation with the people in the room (nurses, scrub techs, surgeons, assists, reps, etc.).  Typically, it’s a jovial atmosphere.  Well, while checking-in with our schedule runner (the czar) a call came through that someone needed to be intubated upstairs.

Luckily, I was in between cases and decided to run upstairs to assess the situation.  I see a rather obese gentleman appearing a bit mottled in color.  The vitals monitor said SpO2 90%.  The patient was on a bipap machine.  His belly was heaving up and down with each breath…making it appear that he was using a lot of effort for each breath.  I called for the intubation supplies.  Sadly, this gentleman had suffered from a cerebellar stroke a week ago and they had attempted an extubation a couple of hours prior to my arrival.  Needless to say, his respiratory effort was wearing me out…and I had already huffed and puffed my way up several floors of stairs (my preferred method of solo transport).  Once the supplies were ready, it was go time.  Labs checked out ok.  He seemed to be moving all extremities appropriately, despite his stroke.  All systems go.  After the drugs were pushed through his central line, I took a look and quickly suctioned his posterior oropharynx — there was mucus covering his glottic opening.  Once it was cleared, I skillfully maneuvered the endotracheal tube through the vocal cords and secured his airway.  The end tidal CO2 detector changed color appropriately and bilateral breath sounds were established.  For those crucial few minutes, everything around me seemed to halt.  I consciously let out a sigh of relief and thanked the RT and nurses who were present in the room for their help.  The beauty of my job is that it’s ever changing. One must be flexible enough to adapt to different types of cases as well as challenging anatomy and situations. Plus, I get to meet all types of people from all walks of life. Therein lies the reason why I love my job.