I was confident today that i will take out the ECG perfectly after i had done it wrong the last 3 times. I pressed the button and the ECG started rolling. The 'first lead' came out good, the second was also nice, by the time i reached the third it stopped. "It must have run out of paper" with these words the nurse put to me in a ease.
I was looking at the 'BPL' logo on the ECG machine and in my head 'Next i'll press this button and then that....' when suddenly my name rings in my ear breaking my analogue thought stream "Sarthak! Sarthak! come here fast". My duty time was already over nearly half an hour ago and next shift interns had already come in. I stayed behind only to do that ECG so that i'd be able to handle things in states of emergency and no hands to help around. Dr. Durgesh had joined the institution as a MO just one month earlier to me and we get along pretty well. He taught me suturing, bandaging, NG insertion, catheterisation and pretty much all the basics of emergency medicine. Just like any other profession that needs team work Emergency Medicine also gets very interesting if co-ordination between partners click off.
Same is with me and Dr. Durgesh who was calling my name at that moment just next bed from where i was standing. A young man of 38-40 had come in about an hour ago with loss of consciousness and alcohol withdrawal effects.We have had the the necessary and the patient's condition were stable. When suddenly Dr. Durgesh noticed 'NOTHING'. Nothing here means a lot, nothing to a militant is Safe, nothing to a teacher is a quite class, nothing to engineer means no errors in calculation, or simply nothing is nothing at all for anyone else but nothing for a doctor is a lot of things because none of the symptoms were present over that patient and we could see no movement of chest or limbs, absolutely NOTHING.
Without wasting any further time i reached the bed and immediately understood what Dr. Durgesh was calling me for. Within seconds my left palm was over my right which was placed over the sternum (mid point of the chest) of the patient. I was giving CPR (Cardiopulmonary resuscitation). "Get me the AMBU bag" - i cried for help to one of the replacing interns who immediately fetched me a over sized egg shaped self inflating air balloon which is used to push in extra air into the lungs of a person who is unable to breath or so. From the other side of the bed nurse was being directed by Dr. Durgesh to push in 1-1 ampule of atropine and adrenaline into the veins of the patient. With every five compression of the chest Dr. Durgesh will punch in a gush of air from the AMBU bag into the patients lungs. The power needed for the surge was so great that each time my body would rise from the floor while doing so, so at last i climbed onto the bed and started again with better stability.
I knew climbing on to the bed was a good idea from this morning where almost a similar situation had taken hold it's grounds and with a similar scenario setup i was doing CPR and Dr. Durgesh was pumping the AMBU. This man was 73 years old, heavily Diabetic and was brought in by his daughter with a hypoglycemic shock. Our profound measures to resuscitate him were going in vain and at last when there was NOTHING we decided to go in for CPR. After giving in all our heart we failed to start their hearts. This followed in the hardest part - Declaring the death of the person to the family.
I was relaxed for i was sure i wouldn't have to do that but did wanted to watch and learn how to do so for my future references when it suddenly struck me 'The MO's were not declaring that person as dead. But WHY?!' This was something new & interesting to me. I knew the man was dead, the MO's knew he was dead, even the family was sure that the person was no more with them but then why was not he being declared dead? What did i missed from the scene? Was there still some hope? All these questions running inside my head and no answers were appearing i decided to ask Dr. Durgesh my only faithful companion in front of whom i could do silly mistakes and expect him to understand.
"Sir, what is going on and why isn't he being handed over to the family?" i inquired eagerly.
"The ECG has to be done yet" he answered simply
"Why to waist ECG when we already know he's dead?"
"We'll it's our clinical proof & we can declare him dead only when the ECG turns flat" He understood my confusion and cleared it out.
But not for long was i satisfied - The ECG wasn't flat. Did that meant there is still chance??? And my very thought was answered by Dr. Krishna who explained the situation to the patient party since they were in a hurry to take the body with them. ECG will turn flat after sometime once the effect of atropine and adrenaline as well as CPR wears off. So until the CPR turns flat the body will not be handed over, death certificate will not be issued and the person will not be declared DEAD! During which so many mixed emotions turned up at the gates where the family is being consoled by the neighbors or by each other. Wives and daughters crying their lungs out and dehydrating themselves up. The only way to neglect all that is to make yourself useful again in saving other lives.
The only humorous incident that happened that i had a bad stiff neck this morning but all the heavy exercise kind of did me good and i could move my neck in all directions again by the end of the day.
I was looking at the 'BPL' logo on the ECG machine and in my head 'Next i'll press this button and then that....' when suddenly my name rings in my ear breaking my analogue thought stream "Sarthak! Sarthak! come here fast". My duty time was already over nearly half an hour ago and next shift interns had already come in. I stayed behind only to do that ECG so that i'd be able to handle things in states of emergency and no hands to help around. Dr. Durgesh had joined the institution as a MO just one month earlier to me and we get along pretty well. He taught me suturing, bandaging, NG insertion, catheterisation and pretty much all the basics of emergency medicine. Just like any other profession that needs team work Emergency Medicine also gets very interesting if co-ordination between partners click off.Same is with me and Dr. Durgesh who was calling my name at that moment just next bed from where i was standing. A young man of 38-40 had come in about an hour ago with loss of consciousness and alcohol withdrawal effects.We have had the the necessary and the patient's condition were stable. When suddenly Dr. Durgesh noticed 'NOTHING'. Nothing here means a lot, nothing to a militant is Safe, nothing to a teacher is a quite class, nothing to engineer means no errors in calculation, or simply nothing is nothing at all for anyone else but nothing for a doctor is a lot of things because none of the symptoms were present over that patient and we could see no movement of chest or limbs, absolutely NOTHING.
 |
| CPR |
 |
| Different age group AMBU bag |
I was relaxed for i was sure i wouldn't have to do that but did wanted to watch and learn how to do so for my future references when it suddenly struck me 'The MO's were not declaring that person as dead. But WHY?!' This was something new & interesting to me. I knew the man was dead, the MO's knew he was dead, even the family was sure that the person was no more with them but then why was not he being declared dead? What did i missed from the scene? Was there still some hope? All these questions running inside my head and no answers were appearing i decided to ask Dr. Durgesh my only faithful companion in front of whom i could do silly mistakes and expect him to understand.
"Sir, what is going on and why isn't he being handed over to the family?" i inquired eagerly.
"The ECG has to be done yet" he answered simply
"Why to waist ECG when we already know he's dead?"
"We'll it's our clinical proof & we can declare him dead only when the ECG turns flat" He understood my confusion and cleared it out.
 |
| Flat ECG |
The only humorous incident that happened that i had a bad stiff neck this morning but all the heavy exercise kind of did me good and i could move my neck in all directions again by the end of the day.
No comments:
Post a Comment