Deadly Errors Read Online Free PDF Page B

more brisk than the left. All findings consistent with the CT picture of swollen brain pushing on the delicate brain stem regions controlling consciousness.
    “Anesthesia’s tied up in the cardiac ICU.” The imaging tech stood beside him now.
    “God, every time you need an anesthesiologist …” He shook his head and recalculated the need to intubate Larry. “Respiratory therapy?”
    “On the way.”
    At that moment the nurse returned with a syringe, a vial and an IV bag. “Here’s the Decadron,” she gasped between breaths. “Give that. I’ll push the Mannitol.”
    “Wait a second.” Tyler held up his hand. “We need to cath him first.” Giving a powerful diuretic like Mannitol without a urinary catheter in place could burst the bladder.
    “I’ll do it,” the tech offered.
    The ED nurse’s brow furrowed, “You certified to do that?”
    “Fuckin’ A.” She thrust a thumb at her own chest. “Served as a navy corpsmen before this gig.”
    Tyler cut off the ED nurse: “We don’t have time for any territorial pissing matches.” To the CT tech he said, “Grab a Foley set and get to work.” To the nurse, “If there’s a problem, I’ll deal with it later.”
    She shot him a withering glare before jerking a blood pressure cuff from the wall holder.
    “Stow it. We don’t have the time,” he shot back.
    From the small glass vial, Tyler drew into a syringe ten milligrams of a steroid to combat brain inflammation. He injected the drug into Larry’s IV line as a respiratory therapist—a Japanese woman, no taller than five feet—jogged into the room. “What’s up?”
    She looked no more than 21 to Tyler. “We need to tube this patient now . You have an intubation tray ready?”
    “You bet, but anesthesia’s tied up for ten minutes or so. Can it wait?”
    Tyler glanced at Larry again. His right arm muscles were tightening into rigid extension, signaling his brain function was deteriorating. “No we can’t.”
    “Well then—”
    “I’ll do it,” Tyler interrupted. “Just get the tray.”
    Soon as the words flew from his mouth a feeling of panic shouldered aside his confident reply. Unlike the well-lit operating room where a few anesthesiologists allowed him to practice this skill, this area had poor lighting and he was wedged awkwardly between the scanner and the wall.
    “All done.” The CT tech pulled the white sheet over Larry’s exposed genitals. Pale yellow urine flowed down the plastic tube toward the collection bag.
    The nurse gently pushed Tyler aside as she wheeled a stretcher next to the scanner. She asked the group, “Ready to transfer him onto the stretcher?”
    Using a plastic transfer board to bridge the gap between the scanner gantry and stretcher, they used the draw sheet under Larry to pull him onto the stretcher.
    A moment later, the respiratory tech rushed in carrying a tray wrapped in a blue surgical sheet sealed with strips of autoclave-sensitive tape. She asked Tyler, “Where do you want this?”
    Tyler sucked a deep breath, glanced around and nodded at a stainless steel Mayo stand against the wall. “Over there.”
    She placed the package on the stand and expertly unwrapped it, keeping the contents sterile.
    Just then Childs’s respirations stopped.
    “Shit.” Tyler’s gut knotted.
    The respiratory therapist shot him a nervous look. “You sure you can do this? I could put some O-2 on him until anesthesia gets here.” She didn’t sound convinced this was such a good solution.
    Tyler glanced at the opened tray and back to Larry Childs. “We can’t wait.”

3
     
    W ITH DELIBERATELY UNHURRIED movements Tyler snapped a medium curved blade onto the laryngoscope handle. Start to rush, you make mistakes , he reminded himself. After checking to see if the light at the end of the blade worked, he pulled the chrome Mayo stand to the head of the stretcher. He told the respiratory tech who was struggling to keep Larry’s lungs full of oxygen by using a face mask