My first patient as the clock struck midnight was the sickest DKA I've ever seen- and I've seen a lot of DKA. She was breathing about 40 times a minute when she came to my room, and her eyes kept rolling to the back of her head like she was about to stop breathing... yeah. As soon as I hooked her up to cardiac monitoring I could actually see on her strip her potassium was going to be stupid high- the final count was 7. Yikes. It took eternity to get an IV on her- I was finally able to stick a neonate needle in vein right above her wrist joint. About half a bag of saline and some IV insulin she started looking like one of the living again, but damn.
A little before I shipped her up to ICU with her insulin drip and a myriad of other shit, another lady, this one in her early 70s rolled in with difficulty breathing and chest pain- not an uncommon sight where I work- didn't think a whole lot one way or the other. Her vitals were probably better than mine but she appeared pretty distressed. I gave her oxygen, which helped her, and did an EKG, which looked fine as well. We sent her for a CT of the lungs to rule out a blood clot- and ohhh wow. She had a GIANT saddle pulmonary embolus. Enormous, like, miraculous you're still alive embolus. We had to give her blood thinners, but she was already anemic from chemotherapy so I also had to give her a blood transfusion. Yeah. She made it to the next shift alright but I'm curious how she'll do later on.
So the last guy I get has poor circulation from diabetes and a yeast infection to his junk. Yeah. He sure did get his foreskin stuck over his glans so tight that he couldn't even go pee. We had to give him moderate sedation to even attempt to put a catheter in the poor guy, and even that didn't work. He was super nice, and a very good sport about the whole thing- they left the whole mess in the hands of urology as I was leaving.
Well, I'm pretty sure I'm just cursed.