18YO M, Near Drowning

“Come with me.” I sat there for a second as the words sunk in. Then, boom back to reality. I grabbed my stethoscope off the computer station. In stride, I joined my attending physician en route to the resuscitation bay. “Your patient” echoed as we entered the room. A medic was in the room, tablet computer in hand. No pleasantries, just the facts, one after another. Mental checklist lit up like the edge of a wildfire. An 18 year old kid was rolled up in the surf, panicked, and inhaled a bunch of water. Lifeguard rescue. Okay, he’s awake. That’s a good start. He’s talking that’s even better. No distress. Why isn’t he on a backboard? Where is his neck stabilization? “Hey bud, were you awake the whole time? …Did you hit your head?” As I reached to feel his pulse, I asked “Does anything hurt?” Normal radial pulse, a little tachycardic, I’ll take it. I turned to the medic, “How was he at the scene?” Okay so his oxygen saturation was a little low at the scene, let’s see what we get here. As I inspected and palpated his body for tenderness and listened to all vital organs, I asked, “Any breathing problems right now? Any numbness, tingling, weakness? Any history of lung problems, asthma, heart problems, seizures? Can you tell me where you are? What is your name? Who is the president?” I ask again, “any pain?” No signs of trauma. Lungs actually sound clear. Oxygen saturation is normal. Patient appears to be stable. Okay, let’s slow this down. I turned to the medic, “Anything else to add?” “Thank you for your work. You all did a good job.” The attending broke the brief silence as I finished up my initial checklist, “What do you want to do for him?” “Nothing besides a little oxygen. He needs a chest x-ray and basic labs.” “Okay, fine with me. Are you going to admit him?” “Not at this time. We’ll watch him. If he stays stable and nothing turns up in any of the studies, then we can send him home.” “Fair enough.” Okay, I have to remember to add him to my patient roster. Now, what in the hell was I doing before this?