I took a glance at him on my way to accompany another unfortunate patient with haemorrhagic stroke to CT Scan.
Hmmm, looks like MVA (motorvehicle accident) with poor GCS- possible intracranial bleed .
That's my spot diagnosis towards the gentleman. So i proceed with my task. When i returned to the redzone, he's already being clerked by my fellow colleagues so i just helped around.
Blood pressure remained low side but no compensated tachycardia. FAST showed no evidence of intra-abdominal bleeding.
Finger crossed, let it just be intracranial bleed and none others. Try fluid first.
Blood pressure didnt picked up. Repeated FAST revealed free fluid over the Morrison's pouch.
Awaiting surgical review.
Let's request for portable CXR as the lungs didnt sound right. Forget about the rest of Xray and CT for now. The patient's not stable enough.
Then it happened,
SPO2 dropped. tachycardia. BP remained low despite blood transfusion. abdomen started to distend. CXR showed multiple rib fracture with flail chest and haemothorax.
Pump the blood.
Prepare the intubation.
Suction! patient's pouring out stomach's content profusely.
Find more lines. Three have been used up for blood.We need one for drugs.
PEA. Time for CPR! but the flail chest?
Insert chest tube. 250ml of blood came out.
Adrenaline.
Atropine.
30 minutes.
Aku naik saksi tiada tuhan melainkan Allah, dan Nabi Muhammad itu pesuruh Allah.
Allah.
Allah.
Allah.
Innalillah...
He was living a hard life with his family. Trying to survive with cutting grass by the roadside. That's when he was hit (and run). No family members was by his side when he met with the Death Angel.
********************************************************
So i ended my chapter in emergency department. Insya Allah, i will be back again with better experience and knowledge.
6 comments:
sedihla post ini....reminds us of our own mortality....
i know i wont survive medicine dari kecik lagi, when i saw a very bloodied man wheeled into OT. mak aku keja kat OT masa tu, i was around 7 or 8 i think.
tabik la kt ko, zila, esah, k.anie etc. mmg sgt tabah. aku rasa aku akan nangis/pengsan hari2.
Ambol: lagi sedih bila sudden death and the family is not prepared for it..
Anis: aku pun nangis gak mula2 dulu, almost quit...tp tak sangka at this point, i simply love what i'm doing...alhamdulillah
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