"Not much to handover tonight, just check this patient's potassium level later. The name of the patient is Maria". It was 8pm & I was starting my night shift. Between 8pm till 8am, I was responsible for all medical patients in the entire hospital & my colleague Sam was just coming off duty & letting me know about the tasks I had for the night.
I decided that a nice cup of coffee & a newspaper in the mess would sort me out before starting some work. Halfway through the sports section of The Times, my bleep went off. The damn thing! It was my registrar, she needed a hand. Maria, the patient I was told about was vomiting blood. She was bleeding internally and blood was pouring out of her ass fast!
When I reached, the ward, I saw Maria, a 47 year-old Hispanic woman semi-comatose on the floor, lying in a puddle of her own blood. She had collapsed while going to the loo. With the help of 2 nurses, we unelegantly hauled her back on to the bed.
Within minutes, we managed to squeeze enough fluid & blood back into her veins for her blood pressure to improve. But Maria was still in a real state, she was barely conscious, pale, clammy and looked like she was at death's door.
While I was dealing with Maria, my registrar called the Intensive Care Unit in the attempt to transfer her there. But when the Intensive Care Specialist turned up to the ward, he was having none of it. He felt that Maria didn't need to go to ITU on the basis that Maria could be cared for on the ward and that the patient was "currently haemodynamically stable".
My registrar & I were stunned out of disbelief. Was the Intensive Care Specialist pulling our leg? Couldn't the numbskull smell the malena (blood)? Couldn't he see that despite 8 pints of blood, her blood pressure was lower than the dead sea?
Fifteen minutes later, this "stable patient" wasn't responding to us & her heart stopped beating. While I was performing chest compressions, I looked up to see Maria's son & daughter standing by the foot of the bed. They were shocked in disbelief. At this point, Maria's daughter cried, "Mummy, mummy speak to us, oh mummy!". With great difficulty, Maria's daughter had to be ushered into the relatives room while we persisted in our resuscitation efforts.
With plenty of adrenaline, atropine & vigorous chest compressions, Maria's heart soon restarted. Alas, our success was short-lived and her heart faded away and stopped beating soon. Again, we manged to restart her heart and again, it would start fading, beating weaker and weaker before stopping completely. For 50 minutes we carried on this desperate cycle of death & life. With each passing minute, our chances of success were fading fast. By the time we hit the hour mark, I knew that we had lost Maria & pretty soon, all efforts were stopped.
When the bad news was broken to Maria's daughter, she was hysterical, "You didn't let me speak to her! Why?!!" It was a horrible feeling, for the guilt I felt. But I seriously doubted we could have resuscitated Maria with her family around.
The rest of the night went by in a blur. When Sam turned up the next morning at 8 am, the first thing I said was, "Sam, I'm sorry, I never did get round to checking that potssium".
3 comments:
That's hard.
Did you tell the Intensive Care Specialist what happened?
Well, the Intensive Care Registrar had to turn up for the arrest call. I must say, he lost the cocky, over-bearing attitude he had only 15 minutes ago.
i'm feeling yah dr. nick. i hate those nights.
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