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Not dead yet?

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I had a dying patient.  She had been on comfort care for several days and was nearing the end.  She was a sweet lady and was surrounded by her sweet family.  If you’ve been reading my blog long, you may know that, if a patient is dying, they will undoubtedly die on my shift.  I don’t know why.

I had tended to the patient and her family throughout the shift.  At some point in the afternoon, the adult daughter came to the nursing station to tell me that she believed her mother had passed.  I paged the doctor and headed into the room.  I felt no carotid pulse.  I auscultated her chest and airway and heard neither heart nor breath sounds.

I tell the family that I think she has passed but that the doctor has to come to declare the time of death. I head out and the doctor (who looks twelve) walks in.  As I ask a co-worker to help me with post-mortem care, the doctor walks up to me.

Doc: “She’s not dead.”

Me:  “What?”

Doc: “She has a carotid pulse.”

Me: “I didn’t feel a pulse and she doesn’t have a heartbeat.”

Doc: “She has a carotid pulse.”

Me: “Okay. Can you stay around for a little bit and go check again because I was pretty sure she’s passed.  I must not be checking right.”

The doc returns to the room and comes back out.

Doc: “I think I felt a fasciculation.”

Me: “I don’t know what that is.  Has she passed?”

Doc: “Yes, she’s passed.”

A medical school education is a terrible thing to waste.