Save of the Month! June 2013

Welcome to Save of the Month! where each month we recognize a resident who went above and beyond to make a great save in the ED. Nominations are solicited from the faculty each block and we pick one resident for recognition and embarrassment on this blog.

This month’s edition goes to . . . Dr. Sarah Melendez!

melendez

Here’s the story:

Sarah Melendez had a great assessment and aggressive approach to a pt with a AAA. There was an elderly man in the ED for abdominal pain. Sarah signed up for him and then the nurse said that the wife stated he had an aortic aneurysm but unknown size. So she immediately went into the room, he was relatively hypotensive for his history and bradycardic to the 50’s but mentating ok. He already had an IV in so she quickly used the US on his abdomen and saw a AAA greater than 7cm with a thrombus inside (no previous imaging or documentation of size in the computer). Immediately placed another large bore IV and started some IVF. Typed and crossed him for PRBC, platelets. His pressure and HR improved with some fluids so she got him to CT scan as soon as the Cr was back, stayed with him in CT and got vascular involved immediately. He had a large AAA about 8cm with impending rupture and fresh hemorrhage within the thrombus. He was consented for surgery and taken to the OR! Sarah–pat yourself on the back–please.