My last day in ITU was somewhat sad. We had a lady who was day 2 post out of hospital cardiac arrest who we had been cooling (it has been shown that cooling people after cardiac arrest can improve neurological outcomes) and then rewarmed her overnight. In the morning when I arrived she began fitting, which is never a good sign. The decision was made after discussion with the family that she should be kept comfortable and we would let her pass away.
That afternoon I was sat writing in some notes at the nurses station when out of nowhere the monitor that shows all of the patient's heart traces started going completely bananas, flashing red and black and making siren noises and screaming VT! VT! because the patient had gone into one of the cardiac arrest rhythms. It gave me such a fright that I literally leapt out my seat, surprised that I myself had not been sent into a cardiac arrest rhythm.
The consultant sat next me very calmly (ITU and anaesthetic consultants are always calm, without exception, something to do with the vast quantity of experience of very sick patients and superhuman level of knowledge they accumulate) wafted me back down into my seat. "We wont be treating this," he said, "this was expected."
Over the next ten minutes I found it both interesting and extremely sad to watch the wavy lines of this lady's heart trace deteriorate from VT into VF, occasionally back into sinus rhythm and then get gradually slower and slower until the last blip vanished and she was in asystole. It's quite unusual to watch this because in most patients people would be actively resuscitating and those not for resuscitation are not usually monitored.
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