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My first call of the month...and it's been a busy one (like always)...I only managed to get out of ED around 2.30am...after setting to resusitation cases in the red zone...both of them had to be admited and observed for head injury. Then I had to attend to a first class patient on the 9th floor. That was not the most troubling part of my call. I had woken up around 7.30am in the morning to prepare myself for the day...As soon as I walked out of my call room, I was encountered with a very interesting, not unusual scenario in the hospital... As I was walking through the ward, I started seeing an elderly lady weeping away in the corner. She called for me, but was speechless to explain to be what is going on. Then she pointed at her husband, and to my surprise, he was lying there, motionless, pale, almost lifeless. This is not the way I want to wake up to...you don't feel that bad when it's your houseman or nurse who calls you for an unconcious patient, but when you find it yourself...you began to wonder what is going on in the ward... I had to scream to the top of my lungs before someone took notice of what is going on...nurses were busy changing sheets, ward HO's were doing their own rounds, medical students were just looking. I had to wait 10 minutes before the cardiac monitor came. We had already started resusitation before that and all of us were taking turns to CPR him, and later intubated him. We had called the anaesthetic team for help, but u can't always wait for them since we don't really know how long this patient has been out...All sorts of drugs went in, adrenaline, atropine, sodium bicarbonate...When the cardiac monitor came, he was really in asystole...we continue resusitating for around 25 minutes and suddenly, he went back to sinus rhythm! It's the first time in my life that I have seen something like this happen...(a miracle perhaps?). We manage to get a BP then, and his stats stabilized until we manage to transfer him to ICU... I was begining to wonder the cause of the event...he was post op 12 hours - a total colectomy was done. Hypovolemia i suppose? I'll let the primary team find out... A reminder to all the medical students and HO's...resusitation! resusitation! resusitation! know what to do...at least then you will have a chance to save a person's life...This is one of the better days, most of the time, the asystole will remain...though I cannot be certain, how much brain damage may have accored while he was in asystole... Post a comment in response: |
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