I tapped a kid today, and it was straight up bubbly, baby! (And I don't mean pus.) Champagne tap! And not in that fake champagne tap way, like it just looked clear to the naked eye. It actually was blood free. ZERO reds on the cell count, as per the lab. I just about lost my shit as I checked the results in the computer, and had to stop myself from running a lap around the ward, draped in the American flag. I knew it was a good tap when I saw the fluid in the manometer, but I was trying to play it off like "ho hum, just in a day's work" because the Neuro fellow and attending were both standing nearby and it probably was no big deal to them. But I think I may have been smiling behind my surgical mask.
It's a good feeling to do something well.
Strangely enough, this is actually my second champagne tap. But the first one I don't even count, because it must have been a complete fluke. It was done on an ER gurney in a curtained-off corner of an inner city hospital when I was a third-year med student on Neurology, and I'm lucky I even knew where to point the damn needle. When I started getting fluid out, I was so surprised I almost dropped the manometer. It reminds me of the first time I went fishing as a little kid, and caught this gigantic flounder on my first cast. (I think I acidentally snagged it on the back as the lure went into the water. The hook was nowhere near it's mouth.) I felt pretty awesome draining the Cristal that first time, but as mirrored by my subsequent luck fishing, almost every tap I've done after that point has been traumatic to some degree. Mostly just a teeny leak of blood that clears quickly, but the worst tap I ever did actually had a big clot in it by the time it got to the lab. Yes, I was intending to send a blood culture in that CSF tube, thanks for asking.
Currently reading: "The Spirit Catches You and You Fall Down." Again. Because I'm on Peds Neuro now, and the case deserves review. Also, I've actually had patients with Lennox-Gastaut syndrome now, so it's interesting to compare them to Lia and see if I think that's what she had.
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