You walk into your next code and it’s a man in his 60s who collapsed on
his way to his cardiologist’s office. His wife insists that he doesn’t
need CPR because he has a kind of artificial heart, an LVAD. No one in
the department has ever seen a patient with one of these before.
We just finished a two-part series with one of our former Chief
Residents, Dr. Zachary Shinar. Zach has been working in San Diego at
Sharp Memorial Hospital and more recently at UC San Diego. What he has
been up to down there is nothing short of incredible.
For a generation of American physicians, the tragic and infamous case of Libby Zion evokes a multitude of feelings. Although the case is best remembered for the enduring effect it had on resident duty hours, for many of us it was the first time that we became familiar with the serotonin syndrome and the seemingly obscure drug interactions that can cause it.
Over the past several months, we have featured a series of interviews
with our resident toxicologist, Dr. Sean Nordt, on the common overdoses
that cause bradycardia and hypotension: calcium channel blockers, beta
blockers, clonidine and digoxin. All of these drugs can be fatal in
overdose and all of them appear on the list of single tablets that can
kill a child.
At the Los Angeles County-University of Southern California Medical
Center, we operate a hyperbaric chamber for the treatment of diving
injuries. Our chamber is located on beautiful Santa Catalina Island off
the coast of Los Angeles. When patients are triaged to the chamber via
Baywatch (that’s right, our EMS providers out on the coast are actually
referred to as Baywatch!), our faculty and residents fly out by
helicopter from the Medical Center to meet them at the chamber.