Saturday, September 1, 2007
OMG! What a terrible night shift! Just had a resuscitation case, unsuccessful... sigh. My nurse told me there's a stand-by, 3 months old found unresponsive, arriving 15 mins. First thing I did was to call my registrar. It helped that 2 days ago, I had a mock code session also on a similar case. I started practising what I was taught theorectically. 1) Call for help 2) Prepare resus drugs. estimated weight for 3 months old about 5kg. IV adrenaline 0.1ml/kg. IV Atropine 0.02mg/kg. IV Normal saline 10ml/kg. IV calcium gluconate 0.5ml/kg. IV 4.2% NaHCO3 2ml/kg. IV D10% 2mg/kg. 3) Prepare intubation set - ETT 3 - 3.5, laryngoscope, suction, bag and mask, sedation drugs (roc, midaz) 4) IV set - include IO needle. and hypocount machine. Waited in the P1 area for the child to arrive. The paramedic came, carrying the child. When we saw the child, he was already in rigor motis, asystole. One person bag and mask, the other CPR. I set the plug, gave the drugs. intubate, NGT, resus drugs, CPR...after half hour, it's time to let go... history is previously well child, found unresponsive on the sofa. nil fever or other localising symptoms. coroner's case. It doesn't help that I started the night with a potential complaint case, and also started the day with a cold. Sigh.. 2 and a half more hours to go before this shift ends. Can't wait!
