LAST NIGHT
Just finished my last night shift this morning, YEAH!!!!!!!!!
I took one dyspnea patient from the side station at 2350hrs and started him on BIPAP. He was given lasix but was not catheterise (AS USUAL!) so we quickly catheterise him and he was much better after poured out 200ml of urine. However our registrar still wanted to put him on BIPAP so we coupled it on. Patient was very much better after an hour but he became non compliant when he was much alert. He wanted to get out of bed and attempted to remove the BIPAP mask many times. I ran out of patience and told him the consequences of him doing all those things. He listened at the point of time but did it again after a few minutes later. I alerted the MO that patient was non compliant so she ordered INO2 since he was much better. His saturation was 100% on INO2 2L and I thought that he will be fine throughout the night but I was wrong. At 0200hrs the patient was in bradycardia so I went to check on him, at the point of time, he attempted to climb out of bed again. He told me he was very hungry and he wanted to walk to the toilet to pee. Shortly after his sentences, his eyes rolled up and he collapsed right in front of me! I turned and shouted "PATIENT COLLAPSED!"... (he was in room 14 with this legs dangling out of the bed, Nathan, remember the incident in room 14 years ago??? Its exactly the same!!!) I attempted to drag him back to the bed but he was too heavy and he was fitting, so I bagged and mask him first. When help arrived, a few of us pulled him up and intubated him, CPR commenced and DC shock given.
In the process, patient just refused to come back. After 40mins he was still consistently in asystole and VF. I shouted out to the patient "UNCLE, come back!" then Roslinda scolded me crazy... No lah its because the family members have not reach the hospital after 45mins of the resus so I thought they would be very sad if he is gone and patient is only 60 years old.... I felt upset for the family members so I tried to "call" him back... Luckily we refused to give up, it was a very active resus. For almost an hour we given 21 DC shock, CPR non stop and many drugs, finally he came back after one hour twenty minutes. He is not doing too well but at least the family get to see him "alive" when they arrived, I wonder how is he now...
I took one dyspnea patient from the side station at 2350hrs and started him on BIPAP. He was given lasix but was not catheterise (AS USUAL!) so we quickly catheterise him and he was much better after poured out 200ml of urine. However our registrar still wanted to put him on BIPAP so we coupled it on. Patient was very much better after an hour but he became non compliant when he was much alert. He wanted to get out of bed and attempted to remove the BIPAP mask many times. I ran out of patience and told him the consequences of him doing all those things. He listened at the point of time but did it again after a few minutes later. I alerted the MO that patient was non compliant so she ordered INO2 since he was much better. His saturation was 100% on INO2 2L and I thought that he will be fine throughout the night but I was wrong. At 0200hrs the patient was in bradycardia so I went to check on him, at the point of time, he attempted to climb out of bed again. He told me he was very hungry and he wanted to walk to the toilet to pee. Shortly after his sentences, his eyes rolled up and he collapsed right in front of me! I turned and shouted "PATIENT COLLAPSED!"... (he was in room 14 with this legs dangling out of the bed, Nathan, remember the incident in room 14 years ago??? Its exactly the same!!!) I attempted to drag him back to the bed but he was too heavy and he was fitting, so I bagged and mask him first. When help arrived, a few of us pulled him up and intubated him, CPR commenced and DC shock given.
In the process, patient just refused to come back. After 40mins he was still consistently in asystole and VF. I shouted out to the patient "UNCLE, come back!" then Roslinda scolded me crazy... No lah its because the family members have not reach the hospital after 45mins of the resus so I thought they would be very sad if he is gone and patient is only 60 years old.... I felt upset for the family members so I tried to "call" him back... Luckily we refused to give up, it was a very active resus. For almost an hour we given 21 DC shock, CPR non stop and many drugs, finally he came back after one hour twenty minutes. He is not doing too well but at least the family get to see him "alive" when they arrived, I wonder how is he now...
3 Comments:
u did well..
By Anonymous, at 2:43 PM
thanks... my fellow colleagues worked very hard for the resus as well!
By Phie Phie, at 3:50 PM
Bala... how can I forget the Rm 14's incident. Totally unforgettable... SO FUNNY.
By Anonymous, at 6:17 PM
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