Quick flight to a near by village for intubation. All in a days work!

So Nome has proved to be interesting to say the least. I get to be a real doctor here. No one to precept, no one to watch over me (I guess it's nice to have that security blanket sometimes). On Wednesday evening I was finishing up in the clinic after removing a ganglion from someone's palm (sometimes I'm a surgeon up here, sometimes a neurologist, depends on the day). One of the doctors asked if I wanted to go on a medivac run, so of course I said yes.

I met with 2 of the flight nurses, respiratory therapist and pilot and off to Koyuck we went. It was a 20 minute flight down where we were greeted by 2 atv's. They drove us down to the clinic, about 1 mile away. We got there and there was a 59y/o male in respiratory distress due to a COPD exacerbation (he had been intubated in the past.) He was grunting and tripoding and so we decided to intubate for the 2.5hour flight to Anchorage. I got to intubate him, place the NGT and the foley. We then loaded him into the back of a pick up truck to get him back up to the "airport." We loaded him into the plane and RT placed him on a vent. I sat near his head so the RN would draw up the meds and I gave them. Can't say I've ever given vecuronium or propofol in the past (kept thinking where are Dr. Schoonmaker and Pace when you need them. Like I know the dosing for any of this. Thank goodness my epocrates works in the middle of nowhere.)

Koyuck was beautiful, even for the little time I spent there. It has about 200 people and the people mostly live on fish. It was very charming.

We landed in Anchorage, took the ambulance to the hospital and I gave report to the ER doctor. We were then allowed 2 hours on the ground. We went to dinner at the Moose's Tooth and went to Wal-mart (when you live somewhere where milk is $9 a gallon, this is a very exciting trip. I bought canned goods, tea, milk and a sweatshirt. It was a great trip.) We then flew 2.5 hours back and I stepped into the house at 3 am and had to get ready for my 24 hour call starting at 6 am. (I'm on q 4 night call while here. I was hoping that Kym and Nik would let this count towards my call tally????). Adventures of my 24 hour call to follow!