A Locum’s ScrapBook: Ports in the Heart-Land

“It’s a program on the rise, as opposed to the matrix of rural or smaller programs out there, that do the meat-and-potatos, day in and day out heart surgery cases, mostly uncomplicated, that so many of us have become seduced by and have taken for granted over the years.”

Editor’s Note:

I’m doing some perfusion traveling as I am taking my show on the road.  As such, every once in awhile I will be dropping a few notes and pictures of places visited, and observations made.  In a sense, the beginning of a scrap book on Open Heart Surgery in America (and other places if possible).

41 hospitals and counting (places I have put someone on CPB).

Enjoy 🙂

Frank

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To view the entire series- click here: A Locum’s ScrapBook.

A Locum’s ScrapBook:  Ports in the HeartLand

So off to clinical site 41- to help out a crew that is submerged in ECMO land, and assist with that, as well as helping out with hearts and call.  Thanksgiving is closing in with it’s usual stinginess regarding time off, and family time.  It seems to always manage to present teams with unusually heavier case loads, and unexpectedly odd outcomes for what were initially benign cases.

So this new town is a little more cosmopolitan than I expected, the hospital is pretty large with a sophisticated and diverse heart program.  On top of one of the towers, a dark, spindly helicopter sits, like a bird of prey waiting for the next medivac, or patient retrieval.  Looks eerily reminiscent of Gotham City from some old, foggy, Batman movie. Level I Trauma Baybee 🙂

Good exposure to the cardiohelp, the Avalon Dual Lumen ECMO catheter (which we seem to be seeing a lot more of these days), VAVD, serious Rapping, TEGs, minimally invasive valves, TAVR’s supported by a modified Cardiohelp circuit (suckers and reservoir added- very creative).

It’s a program on the rise, as opposed to the matrix of rural or smaller programs out there, that do the meat-and-potatos, day in and day out heart surgery cases, mostly uncomplicated, that so many of us have become seduced by and used to over the years.  As a contract Locums, I have chosen the more complex road, and remain aggressive in how I navigate it (in terms with getting up to speed FAST).

ECMO means ICU or PICU (in this case- the former) and of course the tons of new people you are going to meet in the process.  The nurses here are fun.  They can kid around, but are always “on mission”.  Some are training with a mentor, and some are the cheery variety ICU nurse, one of whom comes in with a daily bucket list of “things to get done” on her ECMO shift.  This, while belting out country songs in manic anticipation of the next dressing change, tubing changes, or pretty much anything that involves the term “change”.  She makes a lot of lists, and probably needs a master list to wrangle in any strays or variances that might find her behind the eight ball as opposed to in front of it.  Tuff… And PREPARED.

So now it’s midnight, time for an ABG, and a complete topsy-turvy confrontation with our circadian rhythms as we are still 6 hours out from crawling into some hotel bed at 6:30 in the morning- while the rest of the world wakes up and our patients continue to sleep soundly.

Welcome to the Heart Land 🙂