Saturday, May 2, 2009

Ejection fraction of 4


Patient walked into the ER, and within an hour, fell down, went boom, and landed himself in the ICU with FIVE maxed-out pressors, cooling blanket, CVVHD....everything but a head bolt.

Think about that: ejection fraction of F O U R.

When his heart beats, it spurts out 4% of the blood volume that sits in his heart while it is at rest. How many cc's you suppose that is? If his heart has 100cc at rest (possible, but probably more), it would pump out 4cc at systole.

I can spit more than that.

Jeez, if I'm sleepin good, I can DROOL more than that.

And what does it mean to max out dobutamine and dopamine on a heart with an EF of FOUR? Dobutamine, dopamine, levophed, epinephrine and vasopressin.

The frustrating thing to me is that I don't get to find out what the hell happened to this guy (other than the obvious cardiogenic shock...*why* the cardiogenic shock, I won't know.)

EF of 4. New record for my personal little observations.


CHeSKa said...

what gets me how does that happen? How does a person not realize they weren't sick and they needed help. I don't think i have ever seen them write 4%, we always see <10%. I wonder how old they are and if a VAD is an option.

Andrea said...

I can't help but think about my HIV positive patient with a CD4 count of twelve.

Jennifer said...

You're a great writer! Thanks for sharing!