T`was the Night Before Christmas (in the Cath Lab)

T'was the night before Christmas and all through the lab, Not a creature was stirring, no patients on the slab. The catheters were hung in the guider room with care, Hoping no STEMI soon would be there. The nurses and techs all snuggled in their beds, While visions of coronaries danced in their heads. And the HART team by the phone, my cell in my lap. Just waiting for the call to disturb my winter’s nap. When the helo touched down, there arose such a clatter. The phone near my ear, I answered, What's the matter? Away from my house I flew like a flash. Flying toward Emory, not a car, I hoped, bash. A message from HART, the vent doth blow. A stop in the ER, stabilization, you know. Then QRS complexes wide should appear. A Christmas Eve death, this person should fear. With the defibrillator charging, whining and quick. Shocking v-fib, we knew output Fick. Lidocaine and Epi, by syringe the nurse came. A rhythm on the monitor, soon I could name. Now v-tach and v-fib, now sinus tachy. On Brady, more atropine, Whoooaa SVT. To the heart beating fast At hand is the task To the lab we do go More blood we need flow. As the artery we did open, the pulsations did fly. Past the iliacs to the aorta, the fellow did cry. The attending scrubbed in, a catheter up flew Engaged in a coronary, the dye coursed in too. A balloon and a wire, I did run and get. A laser and AngioJet in the room I did set. A clot in the right, and down the LAD. We’ll be there a while, not this Christmas we’ll flee. We lased and sucked clots as they appeared. Of perforations and dissections, these things we did fear. Shooting dye down the right, t’was huge and so big. The lumen so large, like the nose of a pig We needed a stent, distal protection too Or no re-flow we’d have, stuffed like a nose with the flu. So large was the vessel, we said DES! Bare metal he’d get, we did then assess. We wired the artery, wiggling slowly with care. Progress we saw, at the monitors we did stare. Down the right, the stent it did slide. Across the lesion, in the vessel, time passing by. The balloon was blown up, the stent it got big. The lesion, it was covered, the area, known by trig. The balloon was deflated and pulled back in the guider. Cruising back on the wire, like a horse rider. The touy was closed, pressure checked yet again. A puff down the artery, angiography just then. The coronary was open, the vessel was clear. Remembering the LAD, we had plenty to fear. Up through the long sheath, the EBU goes. Engaging the left coronary, contrast then blows. The left lit up like a Christmas tree, The cloud of clot, brought us no glee. We wired the vessel from one end to the other. Dr. D did it with ease, without even a bother. We aspirated and sucked, this task we’d not duck. Then filtered the blood, with normal saline flood. What was left would amaze; like eggy residue from a glaze. Shooting dye down the artery, we did with a flash. Turning to pressure again, we did in a dash. T’was low, t’was low, echoed in my head. Action was needed or this guy’d be dead. Fluids and neo, we gave instantly On the monitor, rhythm, rate and pressure we did see. The balloon pump was rolled in the room with a whoosh Nobody in the room thought that this job was to cush. In silence we waited for blood pressure to rise. If he survives this event, an ICU bed his prize. We stented his artery, quick as can be. The picture we got made us smile with glee. The balloon, wire and guide came out in a flash. The sheath sutured in, yet he should crash. In the bed, down the hallway, he did roll. Away from the lab, toward the unit, over anyone we’d bowl. We tucked in his legs, snug as a bug. His future to make it, our shoulders did shrug. I headed home to my bed, tired yet fulfilled. Excitement and this job lived up as it’s billed. Auto pilot, my car, to home was its flight. AMI during Christmas. Holy cow! what a night.

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