Wednesday, February 25, 2009
Learning things you wish you don't have to learn it the way you did..
I just realized I've not written about my work for quite some time. I guess sometimes my job description can be repetitive and nothing exciting to blog about as how the weekly tv shows of ER or Grey'Anatomy would be. Hey.. we lead normal lives too you know ; in the midst of haphazardness and madness of the madhouse !
This week the department is a bit short of staff. The seniors are off to their Intensive Course leaving us working extra hard to cover the gaps ! As usual , its up to us the next most senior personnels to do the Senior MO call. Honestly , I am never ready by knowledge and experience to do the call.. but I've been doing it bit by bit since August last year. I have no qualms about it as I figure that the experience I gather during this limited period would help me when I qualify as a specialist.
However yesterday's call was a tough and I am exhausted today. It was not about the severity of the cases but on the out of OT management. I was called at noon ( just after lunch ) when Sherliza was having problems with his post urology stenting patient in the recovery area . His BP dropped and did not pick up. I ran up to help her. We intervened but did not have to intubate him. He recovered his consciousness but his haemodynamics were haywire. We had an excellent ECG machine which showed realtime 12 lead pattern..but it just refused to print it out ! We saw a clear cut ST elevated MI but had no evidence when the cardiology team was there. The 2 other ECG machines that was brought from that building did not provide us with a satisfactory print out.. hmmm.. what was common was it was all from surgical based wards.. hmmmm.. PAtient was then transfered to CCU.. and later on ; we were right. He had a cardiac event with his TroponinT positive.
The later event was disheartening. I was called urgently to help Shakti with a patient of his who suddenly collapsed. We had to run all the way to maternity OT which was a distance away! The due to deliver mother was seen by me earlier when I checked Shakti's epidural in the labour room. When he was called later the patient collapsed in front of him and he had to initiate CPR as she was unconscious with no pulse. It was a nightmare airway as well as he had difficulty to intubate but somehow ( dunno why ) ; he just asked for an LMA from the General OT and it became a useful temporary adjunct to maintain the A in ABC.He pushed the patient to the maternity OT while attempts of "RED ALERT" made by the labour room.
It was controlled chaos in the OT as the OnG consultant performed a superfast Caesarean to get the baby out. My consultant on call was there and we resuscitated her with all our might.Prof was the team leader while INa handled the airway , Zezy the IV push , me with the ACLS protocol and together with Shakti , Sukh and Anand ; we did the chest compressions and defibrillations when indicated . It was a very tiring exercise after 1 hour as the duration we needed to change roles became shorter and shorter. The middle aged lady just did not respond to the resuscitation.
The baby was delivered well but unfortunately it was not the same happy ending for the mother. IT was a really sad atmosphere all over ; a maternal mortality happening in front of our eyes. I hoped that she was able to gauge the syahadah i uttered for her as we were doing the CPR. It was a sad ending to a statistic which we always pray that it would not be us. I guess its qada' and qadar.. may her soul be blessed in the hereafter. In the meantime , i know that my time will be in for a hard time to retrack back what happened in the event in an Official enquiry soon..