Name Heart Rates: Fill & Download for Free

Despite their name, Cold-blooded doesn’t necessarily mean animals enjoy being cold.As you know - it means they can’t control their body temperature. That’s why turtles, frogs, alligators, lay out and sunbathe, pile on top of each other. To get warmer and employ all manner of methods to stay warm.But there are alligators that can survive being frozen:They let their noses stick above the water and it is quite the visual to see - most passersby would assume the alligator is dead.But they’d be mistaken.Alligators and some turtles use a process called Brumation. It’s a lot like the process I described with freedivers, where they slow their bodies down (breathing, heart rate, brain activity) to enable them to hold their breath for stunning periods of time.The alligator’s entire body slows down, requiring much less energy to survive than usual, and far far less nutrition, enabling them to go for months with just their nose above the surface.Shutting your body down is a survival mechanism that spans all of nature (sleep, hibernation, going into a coma).Brumation is just another evolutionary wrench in the survival tool belt.Nature is lit AF.

I had an Australian Shepard once that was my shadow. Her name was Sheila. I was married with 2 children. She would be happy to see them, but she would wait at the door for me to come home everyday. I would get the most joyous greeting every time I came home.If I packed a suitcase, she would find a way to get into the car and stay in the car to try to go along with me. She would act depressed every time I brought out the suitcase.I used to get panic attacks quite often. My heart rate would be very high and I could barely breathe. Sometimes, I would lie in the fetal position on my bed just trying to calm my heart rate and breathing. Sheila would lay down behind me and put her chin across my neck. She felt like a security blanket on my neck. It actually helped calm me down. My breathing and heart rate would improve every time. I think she saved my life. I miss her very much.

Her name was Simone.She was on the younger side, mid-40s, somewhat obese. Only known medical problem was high blood pressure. She spoke limited English, but enough to tell me she had come in for abdominal pain. It was right-sided. She pointed underneath her ribcage. Lots of nausea, some vomiting as well. Said that the pain had been coming and going after meals for the last few months but had been progressively been getting worse.Her initial vital signs looked great, and I figured this was a pretty simple work-up: treat her pain, give her some fluids, get some bloodwork, and send her for an ultrasound of her right upper quadrant to see if she had gallstones +/- evidence of cholecystitis.About ten minutes later I'm called back to bedside; the nurse was unable to obtain intravenous access. Ok, no problem. I get one of our portable ultrasounds and place a line.Ten minutes later, I'm called back yet again. The line I placed stopped working, and two other nurses have tried to replace it with no success.Simone reaches for my hand and says two words: "Doctor. Pain."She's sweating, and looks tremendously uncomfortable. It was about this point that I looked at the heart rate monitor and noticed that her heart rate which had been in the 80s was now in the 100s. Hmm."Let's give her some more pain medicine--I'll put in for intramuscular."Nurse goes to get the medicine. I'm about to step away for a second to check the computer to see if there are any labs back, when Simone's heart rate jumps to the 120s.Um. Yeah. Don't think that's purely due to pain. Med student memories wander through my brain, and one line sticks out: "Vital signs are vital.""Simone? How are you feeling right now? Your heart's going super fast.""Just pain, doctor. Pain."Her eyes are closed. She's mumbling. She wasn't mumbling a little while ago. When did she get so sweaty? Skin's now feeling quite warm to touch. She starts shaking a little bit. This...this doesn't look good.Heart rate: 160s. Oh fuck.We wheel her as fast as possible to a higher-acuity part of the emergency department. On the way I grab my attending: "I think she's got ascending cholangitis, this looks like septic shock."He nods. "Let's rock and roll."Heart rate: 180s. Goddamnit, do not go higher. Please do not go higher."Simone? Simone! Hey, wake up for me!"No response. Oh god. Do we even have a pulse?I feel her neck. Yes. Good. Positive thoughts. Need positive thoughts right now. I slap defibrillator pads onto her, seriously thinking she might go into cardiac arrest. She's got good oxygen saturation for the time being, but my airway kit is at bedside ready to go in case we have to intubate. Positive thoughts."Boss, we need access. Central line?"My attending nods and wordlessly begins setting up equipment for me while I gown up."I'm giving you one shot at this. Get it."To this day, I still think that's the fastest central line I've ever done.Heart rate: 220s. Temperature: 104.2.FLUIDS. ANTIBIOTICS. ANTIPYRETIC. GET READY FOR A CODE.I keep two fingers on Simone's wrist hoping I don't feel her pulse stop. We slam liter after liter into her and over the next twenty minutes her heart rate slowly comes down. Antibiotics are now in. Bloodwork is back and looks crappier than expected. Bedside ultrasound shows an utterly enormous gallbladder. The GI service agrees that emergent ERCP is the right approach, and asks us to bring the patient up ASAP.I go with the patient upstairs to the procedure room and relay what's been happening to the anesthesiologist, the nurses, and tech staff. They take over, and I step out. It's done.When all of this was happening, I didn't really have time to stop and think about how I felt. I just did what I thought was necessary to stop Simone from dying, wracking my brain for anything I could do while also preparing for what would happen if throwing the kitchen sink failed.When my part was over, I felt overwhelming relief. Hallelujah, it worked. We did it. There was a rush of joy, the taste of victory.The hard part started when I went home that night. I relived every minute in my nightmares for weeks. Her face. The way her heart rate soared. The moment she stopped responding to me. The poke of the needle into her neck. Each night I would dream that I'd screwed something up and caused her to die.It was, honestly, kind of miserable. The patient did well in the end but there I was, constantly reliving the scene in my dreams as my brain poked at every possible insecurity, cross-examined every action looking for errors and showing me what could have been.As an intern, it made me question myself. A lot. What could I have done better? Could I have responded faster? If I was smarter, could I have foreseen the impending storm? Was there something on my initial physical exam I missed? Could I have done anything to prevent that first IV line from clogging?At some point I learned to accept that I did the best I could. I moved on. I still remember Simone vividly. Her story still haunts my dreams from time to time. But I get up each morning and I keep going forward. I learn a little more. I get a little better. And I keep trying. What more can I do?Nota bene: details of this story have been (drastically) altered to protect patient privacy.