Speaker 1
In our fourth year, we spend certain month-long blocks at other hospitals, it's called an away rotation, and I was doing one of these away rotations, I was in California. Emergency medicine is shift-based, so you work hard on your shift, and then you go home. I was leaving a shift late at night, I think it was around 1:00 or 2:00 AM, and on my way out I noticed a patient that was just sitting in a hallway bed waiting to get placed in a room, and he was sweating, which is never really a good sign in the ED.
So I go to chat with him, and I just say, "Hey, I'm just a medical student. I'm not part of your care team. Just saying hi, what's going on?" It turns out he had a blood clot diagnosed in his leg like six days ago, and he had been unable to pick up his blood thinners to remove the clot.
One of the scariest things in emergency medicine is when a blood clot in the leg can travel back up through our major veins into our heart and then into our lungs. That can be a life-threatening emergency. It's called pulmonary embolism. And I had a toolkit, wake had given me a toolkit. I had just gotten off a month-long block of ultrasound, where my director, Dr. Zabitz, told us, "You need to practice these until they're boring." And I was trained to do an ultrasound of the heart at bedside. Ultrasound is noninvasive. It's quite safe. It's one of our safest imaging modalities, and it is such a cool tool to not just treat people, but make sense of the human body and what's going on. I think Wake has recognized its learning value, and we are lucky to have the resources at our disposal to develop a good ultrasound understanding.
So I run and grab a probe, bring it back to this guy, put it on his chest, and immediately, as soon as I put the probe on his chest, having done dozens of these, I saw something pretty scary. The right side of the heart that pumps blood into the lungs is usually a little bit tinier and weaker than the left side that pumps against all the resistance in our body. In his case, the right heart was not only getting bigger, but there were signs that it was building up some pressure. It was beginning to bow into the left side of the heart, way more pressure than there should have been.
I saw what I needed to see. I clicked save the image. I think I literally ran and grabbed a resident. I said, "Hey, this person needs to go into the CT scanner. He's in trouble." And they believed me, we got him in the scanner. Sure enough, he had multiple blood clots in his lungs, and they got him on Heparin really quickly. They called the ICU. And I came into work the next day, and I went to go see him, and he turned out doing really well. And that was really cool, and I think I owe that almost entirely to Wake and how they train us in ultrasound from literally day one.
