Just got word that several additional medications have been added to the national list of “drug shortages”. Doctors better start learning more about wilderness medicine at this rate.
I can see the management of our next unstable patient now …[Call comes in on telemetry line] “We’re coming to you with a 44 year old male hypotensive and unresponsive. Short transport time.”
[15 minutes later, the crew arrives] “Sorry it took so long, our ambulance ran out of gas because we couldn’t afford to fill the tank due to the high gas prices and low Medicare/Medicaid reimbursements. We had to call for assist with transport from the Amish Ambulance Service with its horse and buggy. By the way, do you know where I can get a broom and a very large shovel?” [Patient is hooked up to the monitor. Wide complex bradycardia. Pressure 60/40. Dialysis graft is noticed in his arm.] “Dialysis patient. He may be acidotic and hyperkalemic. Give him an amp of bicarb STAT.”
“Sorry doc, we’re out. There’s a national shortage.”
“Keep that fluid bolus going. Let’s start some Levophed on him to raise his blood pressure.”
“Sorry, doc. We don’t have any of that either. National shortage.”
“Well let’s at least give him some Vancomycin in case he’s septic.”
“I’d like to, but I can’t. That’s on national shortage, too.”
“Well, he’s not responding very well. At least let’s get him intubated. Can someone push some Rocuronium?”
“Don’t have that, either. National shortage.”
“Nope. That’s out, too.”
“Nope. National shortage.” [patient now loses his pulse] “He’s CODING! Start CPR. Give him an amp of epinephrine, STAT.”
“Sorry, doc. National shortage. Don’t have any.”
“OoooKayyy. Give him an amp of atropine, then.”
“Don’t you know that atropine isn’t part of ACLS protocol any more? Besides, we don’t have any and there’s a national shortage of atropine, too.”
[patient is unable to be resuscitated and dies]
Six weeks later, the doctor receives a letter from the Arizona State Nursing Board [for those who don’t regularly follow this blog, this is parody — background here] informing him that he is being investigated for failure to properly manage the patient and failure to properly look out for the patient’s best interests, too. He must submit to a psychiatric evaluation, must submit to a genetic test to assess his future intellectual capacity, and must submit to a hearing in front of the whole nursing board to explain himself or else his name will be posted somewhere on the Arizona State Nursing Board’s web site and he will never be allowed to be a nurse in Arizona.
“I think I’m going to be sick.”
“Hope not. We’re out of Zofran, too. National shortage.”
Good thing I had extra coffee and some old jumper cables laying around to jolt my heart back into a normal rhythm after seeing the Instalanche! Thanks, Glenn!