Day 21, I knew he looked awful, he was sweating so much earlier and he could barely speak. I can hear his chest from the end of the room, looks like there’s a bit of blood in the face mask. The xray looks horrible, it’s probably TB but I ought to treat him for everything, I almost can’t believe his status is negative. I’ve already got him on broad spectrum antibiotics and as hi flow oxygen as we have, it’s ridiculous that we don’t have 100% O2 masks. Is there anything else I can do? He doesn’t look too wasted and he isn’t really very old. I can just pummel him with fluids, antibiotics and see how he does...
...Ok, I better go and check him out again, the nurses seem to be getting concerned. Balls! He’s about to tank it, better get some help. Ok, so Jo’s on the compressions, need some gloves and the resus trolley. Surely we’ve got to try, he’s not even positive, let’s start bagging him and call the others. How about one of you nurses start timing and give us an airway while you’re at it? Yeah I think adrenaline would probably be a good idea, I hope someone else can take over soon, I’m getting knackered...
...So what do u guys think, try intubating him? I forgot about the guy in OPD who was being ventilated, and I guess what is the point if there are no ICU beds in the whole province because of the strikes. We managed to get the pulse back, let’s try and do something for him. I’m happy to keep bagging and his pupils still seem OK. Fair enough intubation isn’t an option and he is making some respiratory effort. We haven’t got CPAP, do you think chest physio could help get some of the secretions off?
Well we’re agreed, if he arrests again we shouldn’t resuscitate him. Is the physio helping? We should find out about the bloods from the morning. Damn, his kidneys are in failure as well. He’s going to need a catheter and lets up the antibiotics. Well if he makes it through the night we can try and refer him again tomorrow...
...He’s gasping. That’s probably going to be as much as we can do. His wife thought he was gone the first time, if you’re OK talking to her then I’ll document. “Not for further intervention at this time, plan – keep comfortable”.
Awwww, that all sounds lovely.
ReplyDeleteI'm glad to hear you're enjoying your gap-year, Hakuna matata!