The other day...

I am old.  There, I said it.  I actually am proud of it.

However, being old means I have had some experiences, which is what has ultimately made me old.  The most important lesson I have learned in my life, is to STOP!  Stop, think, observe, plan.

My last shift, I came out of a patient's room, to see a bunch of people running into one of my other patient's rooms.  This caused some concern and I myself responded.

When I entered, there were several nurses and techs all moving and doing.  I simply asked, "What is the problem?"  As defib/pacer pads where being applied, a 12-lead EKG being done, blood pressure being cycled... I heard, "the heart rate is 250!"


I looked at my patient, Roger, and asked him how do you feel?  He replied, "Just fine.  What's all this about?"

I glanced at the cardiac monitor.  It was 'alarming' indicating a heart rate of ~250... yet a glance down at the SpO2, indicated a HR of ~100...  I announced "The HR is 110, look at the pleth wave."  To which I was shown a rhythm stip showing an Atrial Flutter, variable, 2:1 to 3:1...

As things were quickly escalating, I said, fairly loudly, "STOP!"  Everyone did.

I walked up to the bedside monitor, changed the EKG lead from II to I, and the alarms instantly ended.  HR was now ~100.  A radial pulse check (yes, I actually touched my patient, ungloved), confirmed.

I turned to everyone in the room and said, "The monitor was reading the 'flutter' waves as 'QRS' waves."  And then the sage advice, "Treat the patient, not the monitor."

I reassured Roger and his family that everything was OK.  I also apologized for the scare... as no one had addressed the patient or the family.  As I turned around, I noticed, I was now the only ED person in the room.

When a critical or emergent condition exists, I want my peers to react.  I only expect that they do so appropriately.