Chapter ## : A story after Night Shift

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Second : Continue Reading.. heee..

I finished my night shift this morning.. And last night was my first time writing death report of a patient.. Sort of mortality report..

She was a 30-year old woman, married.. First admission to ICU because of deteriorating GCS.. then she went to Hospital Raja Permaisuri Bainun to do MRI.. then readmitted to my ward.. on ventilator support via tracheostomy (in view of prolong intubation in previous ICU). Patient also developed MRSA as well as MRO during hospitalization. She was admitted to my ward because there was no bed available in ICU.. She was diagnosed as meningoencephalitis. they said she was conscious but still on ventilator support. She had skin breakdown at scalp - most probably due to prolonged bed-bound.. and stage 4 sacral sore.. which need to be debrided, and been debrided but not so much of a healing.. she was put on adrenaline due to decreasing blood pressure, but then bp not so much a problem for her after adrenaline.

Few days before, she had blood-stained and sometimes fresh blood on secretion via trachy, oral, and nasal. Hb became lower and lower. She received 4 pints of packed-cells. last hb was only 9.2. because of bleeding retrieved from suction, trachy was removed and ETT reinserted by GA. There was actually lots of bleeding from the site.

My first night shift, at around 5am, when i wanted to do suction, her SPO2 (oxygen saturation) decreased until 34%. I have to bag her to ensure nothing's wrong.. then the anesthetist adjusted her ventilator.. okla.. but no improvement on her secretion.

My third night - after taking her report, and the bed after hers, my colleague said she was bleeding from the tracheostomy wound.. so we attended her and bag her together with my HO and ICU's MO. everyone was concentrating on her pulmonary part.. I have a feeling that she's into asystole already. once we attached the cardiac monitoring - its true - asystole.. terus melompat MO tu buat cpr.. huhu.. skali ngn HO aku.. heee... aku pulak bagging la ngn my colleague doing the suctioning.. 3 rounds of adrenaline and atropine given, but yeah, it's her time to go..

thus, officially, my first death report in my career.. huu...

anyway, as usual, I love it when my job is filled with adrenaline at times (of course, not at all time.. )huhu...

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