Save of the Month! November 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. Nathan Reisman!

Here’s the story . . .

A patient with varices and cirrhosis presented with hematemsis. They were initially hypotensive with a poor mental status. Nathan quickly put in a femoral cordis. The patient received 1L NS and 2 units of pRBCs in 20 minutes using the level one infuser. The pt stabilized and felt much better. Ninety minutes later the patient decompensated and coded in front of us. Nathan then performed a very difficult intubation with active hematemesis using a bougie and laryngoscope. During the resuscitation the peripheral lines were lost and Nathan performed a supraclavicular approach to a subclavian line while compressions were being performed to give medication while blood was transfused in the cordis. After 30 minutes of resus, the patient stabilized and made it to the ICU where GI was able to perform endoscopy. Throughout the patient’s resuscitation Nathan was calm and in control of the situation. I was very impressed with his procedural skill, critical management and poise.