Saturday, 7 December 2013

My first time.

My first time as an attending Dr to an unresponsive patient. Is not cool. Not cool at all.

It was on my night call. The first night call ever in my new ward. I was expecting a peaceful night. With less admission compared to my former wards. Gastro ward wa so much hectic than nephro, which is my new posting. I was dealing with a difficult blood taking when respi ward, the ward that I'm covering for other than nephro calls, saying that one of the patient is not responsive. I immediately abandon Mr difficult and run to respi, which was just right next door. And the first sight that welcome me in respi was the nurses pushing the emergency trolley into the isolation room. and I just know that it was serious. That I'm gonna deal with someone's life. Without further delay, I just grab a normal facemask and went in to assess the patient.

The sight of the patient is aint pretty too. She look .... well.. numb. Rigid. The first thing that I did was check the patient's carotid pulse and auscultate for her heart beat. And I can hear nor felt none. After making sure that she has not been issued DNR and was for active resuscitation. I did the first thing that came to my mind. No time should be wasted. Every second waste could lead to cerebral hypoxia. And so, I just went up the bed and start to do CPR.

I was in doubt at first, whether CPR should never be commence without guidance from my superior. That maybe I was wrong, maybe the pulse is there but it was me who was unskillfull in eliciting the signs. But, my inner instinct get me through the night.

I ordered the nurse to call my superior and the other to check her pulse and blood pressure. Both were none recordable. But the heart activity was present with the CPR going on. I got high adrenaline rush that I can get myself to do CPR for 15~ mins straight. (Which never happen before this)

My superior came around 5 mins after I start doing the CPR and the patient was immediately intubated. But sadly, even after 1 hour struggling to keep her alive. She didn't make it.

That's why my first time as an attending Dr to an unresponsive patient is not cool. Not cool at all.

But on the bright side. I'm glad that I didn't cower in fear and do something stupid at that time. I'm glad that I can take action. And from this, I became aware of the things that should be done during an active resuscitation. And I believe I could do better next time.

But still, I loss a life last night. :(