19 year old
asthma attack
Ordinary monday morning albeit a cold one. A young man collapsed in a busy ER shortly after arrival at the counter complaining of breathing diffulty. A scruffy looking young MO on his way out after his night shift jumped into action. The intubation was smooth, however that hospital had just ran out of its last ICU bed to a 49 year old attempted suicide.
A prompt referral landed the unfortunate lad into our ICU.
The first 24 hour was an uneventful predictable recovery. Then the trouble began. At midnight he popped out his lungs resulted in bilateral pneumothorax, chest tubes were inserted.
Then his kidneys decided to shut down, most likely pre-renal failure, resulting in serious metabolic derangement. His acidosis creeping up so badly the nephrology team had to dialyse him preventing from further blood toxicity that can kill him.
36 hour later his heart slowed down, hence the first CPR. We revived him.
From then onward his condition spiralling down by the minutes.
"He has multiorgan failure, I'm afraid his condition is now more critical than before" My boss explained the situation, carefully selecting his words, to the boy's parents.
asthma attack
Ordinary monday morning albeit a cold one. A young man collapsed in a busy ER shortly after arrival at the counter complaining of breathing diffulty. A scruffy looking young MO on his way out after his night shift jumped into action. The intubation was smooth, however that hospital had just ran out of its last ICU bed to a 49 year old attempted suicide.
A prompt referral landed the unfortunate lad into our ICU.
The first 24 hour was an uneventful predictable recovery. Then the trouble began. At midnight he popped out his lungs resulted in bilateral pneumothorax, chest tubes were inserted.
Then his kidneys decided to shut down, most likely pre-renal failure, resulting in serious metabolic derangement. His acidosis creeping up so badly the nephrology team had to dialyse him preventing from further blood toxicity that can kill him.
36 hour later his heart slowed down, hence the first CPR. We revived him.
From then onward his condition spiralling down by the minutes.
"He has multiorgan failure, I'm afraid his condition is now more critical than before" My boss explained the situation, carefully selecting his words, to the boy's parents.
The mother cried hysterically. The father had a lost look on his face, speechless.
The night before my on-call duty, my friend had to CPR the poor chap 4 times. He survived.
"He's on 4 inotropes now.. but looks like the heart is giving up slowly, BP was labile all the way. The asthma also showed no signs of fading away, the bronchospasm is quite resistant and getting more frequent despite our IV salbutamol, ketamine, MgSO4 and the isoflurane.. good luck bro" Johan was less cheerful during the pass over, he didn't get any sleep last night. The dark spots around his eyes tell it all.
"Yeah.. well I gonna need that" I knew right away, it's not going to be a quiet night.
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The phone in my on call room rang exactly at 8pm.
"He arrested!" a nurse sound alarmed.
"Start CPR! I'm coming" less than a minute later I found myself on top of him, compressing his chest, pumping blood into his circulation. I palpated his corotid artery searching for sign of life...
(....to be cont)
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