NEW YORK, NY – A pulmonary team at New York Medical Center (NYMC) narrowly avoided an overnight ICU stay for BIPAP or ventilator support after medical staff found them winded, tripoding, and extremely hypoxic yesterday afternoon after making the extremely rash decision to climb up seven – that’s right, seven – flights of stairs.
“I’m… motivated… by… my… Fitbit,” explained pulmonologist Laura Hopkins to her caretakers yesterday, her accessory muscles visibly working overtime. “Almost… at… 10,000…” Witnesses believe she said “steps,” though it was difficult to hear her over the face mask.
According to reports from several nurses on the seventh floor at the time of the incident, Hopkins and her physician assistant Jason Besh were first identified by their heavy, lethargic steps approaching the floor upon completion of the seven-flight ascent. They threw their arms over the nurses station before their legs gave way, each whispering, “I’m too young to die.” The gasping and wheezing alarmed the nearby staff and a rapid response code was called overhead.
“In the same way it’s alarming to see a gastroenterologist having a rectal bleed, it’s shocking to see your pulmonary colleagues with oxygen saturations in the 80s,” said respiratory therapist Shannon Brock, who wisely decided to take the elevators and has an oxygen saturation of 99% on room air. “I love intubation, but I don’t love intubating my friends.” Hopkins and Besh had oxygen saturations of 86% and 81% on room air, respectively.
Several others who normally wouldn’t have responded to the code offered their assistance once they realized it was a pair of friends and colleagues in need. Emergency medicine physician Craig Hastings offered to “empirically start broad-spectrum antibiotics, Lasix, albuterol, Solu-Medrol, aspirin, statin, morphine, and a heparin drip,” while infectious diseases nurse practitioner Helen Acheson “offered HIV testing, a lumbar puncture, and a flu vaccine.”
The rapid response team ultimately took charge. The pulmonary pagers were momentarily turned off to eliminate any influence of pager-induced hypoxia, and with supplemental oxygen, deep breathing techniques, and a few albuterol treatments for good measure, the pulmonary team was back to their baseline. Hopkins and Besh were counseled on the importance of both tobacco cessation and elevator compliance.
“Lesson learned,” said Besh between breaths on his incentive spirometer. “That’s why elevators were built in the first place. Climbing stairs is a form of altitude sickness.” He added later: “There’s a reason you never see a radiologist with hypoxia.”