Emergency treatment is the area that I seldom have chance to meet if I back to Malaysia, but if I meet the situation that need me to save a patient from cardiac or respiratory arrest, I should have the ability to do so. After all, I want to be a good doctor.
Everytime after I read and recite this skill noted on book, I can’t simply remember the procedure, but that day, something happened.
Weather is piece in that sunday morning, but the things going to happen is really urgent. Doctor Jyao, with long, curly hair, always treat others kindly, but she was troubled by plenty of case that make her can’t even take a rest for minutes. She kept walking up to 13th and down to 12nd floor of ward. A patient of other floor that waiting for her consultation have to come to 13th floor himself because she was too busy. Doctor’s face became tight, the smile that always on her face disappeared.
At around 5pm, she was told that the patient of 12nd floor is not going to make it. I was curious and followed her. Before this, I had heard that 12nd floor have more cases that need to do CPR and suction. I was present at locale minutes later, Doctor Jyao stood in crowd, taking charge of the first aid. The expression of family members was upset, the scene was under serious pressure, nurses was in rush to make injection. "Adrenaline", a drug for stimulating cardiac muscle and circulation was ordered to inject. I was standing aside, not dare to make sound, observing the condition of patient, she’s above 80 years old, thin, creasy, grey-faced, unconscious, heart rate 35 time per minutes, blood pressure was not able to be detected, respiratory was very weak, about 10 times per minutes. She was facing a big problem that phlegm in trachea block her breath, two nurses was pulling the suction equipment with a bottle of 500ml normal saline approaching. While they were executing the suction, the heart beat suddenly stopped. Doctor Jyao inquire doctor of respiratory department and family member whether the execution of ventilator is needed. Under the reason that the patient was too old and the condition was too serious, the family member decided not to execute ventilator. Under this circumstances, doctor executed cardiopulmonary resuscitation. It was so fast that they pressed almost two times a second. Its a tired job to do pressing for hundreds times, so, I was asked to give help, that was my first time doing artificial cardiac compression. Those information of ABC kept occured in my mind, 1/3 lower part of breastbone, 100 times per minute, 3 to 5 centimeter deep pressing…… However, artificial respiration was execute after minutes when endotracheal tube from anaesthesia department arrived. In the progress, I notice that when the pressing rate was about 120 times per minutes, the heart rate in the screen can be exist but if the pressing rate was below 120 per minutes, it showed nothing. I think the effect is better at the rate 120 times per minute.
The whole progress was about 25 minutes, the end was a tragedy, the patient was announced dead finally.
Hope the patient rest piecefully in Heaven.
After this experience, I really won’t forget the detail of ABC anymore.
道法自然体系 