I did a search this morning, read about pancreatitis. Have some questions about the way he's being treated, but then so does the rest of my team. Switched to a broad-spectrum antibiotic with good pancreatic penetration although I don't think they did it for the reasons I was thinking. (Medline question - do we even need antibiotics in someone with mild to moderate pancreatitis?) He has a rising WBC so we're worried, especially with his fever. And the ultrasound shows cholecystitis (inflamed gall bladder) so he's going to need that out too. Surgery wants an ERCP because they can, we think. They shouldn't need one, he's passed the stone and his LFT's are getting better. They have an NG tube down for the same reason, it seems, because he hasn't been vomiting since he got here. Silly Surgery.
Called O to tell him that I only have one patient. He'll fix that.
Did you hear, Evelyne-the-PharmD-student says to me, about poor Mr. V? I hadn't. He went to get his EP study and died.
V came in with a foot ulcer that needed some IV antibiotics. He had a bad heart, we knew that. We didn't expect, however, that he would suddenly go into a fast but stable V-tach. We also didn't expect that it would take 12 hours and all the drugs at the cardiologists' disposal to break him out of it - since his pacemaker was going spastic trying to stop it and had to be turned off, since shocking him didn't work. But they did break him out of it, and they scheduled him for an EP study. That's where they go poking around in the heart to find out where the bad section of heart is and *zot* it. It's a dangerous thing, because you're inducing arrhythmias, but it usually works out okay. And they only do it when things are dangerous to continue the way they are.
Apparently, they found two and zotted them, then he went into V-fib and they couldn't stop it. And he died on the EP table, in front of a room full of cardiologists. Go figure.
And now it's time to go to lunch and learn about the Gopher system here. I need more Gopher education, oh yes. Besides - free pizza, who can complain?