I crashed my first probe last night

[magical thyme]

Last night was 3 years to the day since I started my clinical training, and in all that time I never crashed a probe. "Don't crash the probes!" we were warned over and over, by sr. techs who had crashed many a probe in their career. And over and over, I heard from one student after another who had crashed a probe that day . Somehow, I always managed to avoid the trauma and shame. I came close a couple times, but in the last instant, woke up and got the effing cap off in the nick of time.

The challenge is this. Half the instruments are "open cap," that is, we remove the cap off the blood tube before inserting it into the instrument. The other half of the instruments are "closed cap," in which we leave the cap on and the instrument probe has a lancet that pierces the cap to get to the blood.

So you need to remember where you are and what you are doing. Which seems like a simple task, but when you're new and overwhelmed you forget where you are. And when you're not new, but you have somebody coding and your running at top speed and multitasking, you can forget exactly where you are. It's hard to stay in the moment when everything is going so fast it's a blur and the moments overlap.

So I picked the night when we had a patient come in coding to have my maiden probe crash.

As far as I can remember, I had just put the ammonia tube on to spin (cap on, or you'll spew blood everywhere) and was about to race back to CBC (cap on or the tube will empty out into the instrument when it turns it upside down to mix the spec). So I pulled the chemistry tube out of the spinner, and then the ammonia tube out of the bag of ice, put the ammonia tube into the spinner and started it up, and then ran over to the chemistry analyzer and threw the tube on without first removing the cap. I vaguely remember turning the tube to check for clots, and then my memory goe blank and I'm back in hematology pulling the slide out of the stainer to do the differential.

Fortunately, the night tech was doing chemistry but had just run down to the ED to deliver some uncrossmatched blood. He came running back a couple minutes later expecting to put the spec on himself and discovered I'd done it to help him out , and because he has many, many years of experience, recognized immediately why the instrument was alarming "short spec," knew how to interrupt it and get the tube out so he could get the cap off, the spec was only delayed by about 3 minutes, and was done in the same time had I left it for him to run. So at least I got the ammonia spinning for him, which was a help.

Shortly before that all happened, the night tech started to melt down, which is incredibly rare for him. First when he couldn't find the form for the doctor to sign off on for uncrossmatched blood, and then after he found the form, and started yelling I can't believe we have this #$%@#!!!! paperwork when a patient is $#%@#$!!!! coding!!!! And I yelled back that he has 24 hours to get the form signed off, just get the blood to the ED!!!!!!!! and he was phew! and off and running.

Anyway, fortunately it all worked out and the patient's chemistries were the least of the problems, since the ABG was not compatible with life, and various and sundry other results were critical, off the charts, etc. Although the chemistries did ultimately corroborate the ABG's total CO2 result. I don't know if the patient made it or not. They cancelled the crossmatched units and returned a unit of plasma, but later there was still a group of people in the room with the patient. And then an order came through for a urinalysis and we were all like

Anyway, even before the code, it was kind of a crazy afternoon and I'm still all and feel like god hates me for letting me crash a probe during a code of all times. What an effing lousy way to have your first probe crash. The good news is I will probably never in a million years crash a probe again because that kind of mistake made all the time will seem routine, but the first time in that particular situation means it will stick forever.

[Baitball Blogger]

1. I'm going to guess that you've read "The immortal cells of Henrietta Lacks."

That's the closest I've come to understanding lab work.

[magical thyme]

2. haven't read it...

I read something about her and her cell line somewhere along the way, but all my reading during 2010 and 2011 related directly to my training, i.e. textbooks only. I simply had no time for anything else, not even the paper.

[Baitball Blogger]

3. It is an exceptional researched work which describes many developments of

lab work procedure by following the biography of a woman whose cells were harvested without her knowledge. It is an intriguing story of medical ethics, lab work procedure and how early ignorance and arrogance routinely exploited patients who relied on public medical assistance.

It's the whole enchilada. Chapters are short. Read one every night and it will take six weeks, tops.

[pinboy3niner]

4. In the hospital, a nurse came in to give me a penicillin shot...

Walking into my room, she dropped the syringe on the floor. She gave it a quick look, saw that the cap was still on, and headed to my bedside.

The nurse then removed the syringe cap and jabbed the needle into my butt. Except it wouldn't go in. So she jabbed again, harder. It still wouldn't go in. She tried a third time, even harder, and it still wouldn't go in.

Only then did she examine the needle--which was bent into a corkscrew shape from dropping it on the floor, even with the cap on. That was a painful learning experience (the learning part was hers, the pain part was all mine!)

I guess you could say she crashed my probe...

[magical thyme]

5. YOUCH!!!!! now that's a probe crash to remember!!!!

Sorry for your buttpain, though...really, I am!