Dengue! revisited

Once upon a night.

All ICU patients were stable. So I went up to surgical ward on the 7th floor to do a quick follow up on a newly discharged patient. The elevators on the east wing sometimes went cookoo late at night.

"Dang! the lights are not working again, this is just what I need... alone at 12am, inside a dark hospital elevator" I chuckled nervously.

Suddenly my handphone went off Justin's SEXY BACK tune.

It's the ICU. "Doctor, turun cepat ke ICU, adik Nizam berdarah keluar dari ETT... restless!!"

Aiyayayaya! It's the dengue shock case.

Nizam is your typical high-achiever Malay boy from Cheras who's also in his school's hockey team. A decent lad.

As I reached the 7th floor, I hit the button back to the ICU floor.

"Double Dang!! another trip in pitchblack darkness"

Yaikkks! I almost jumped out of my skin when I feel a soft tap on my left shoulder. I moved my back against the wall. Wadefak was datttt?

*****

"What happened?? He was okay 20mins ago" I asked the nurse who's looking after Nizam. She gave me the "YOU'RE THE DAMN DOCTOR... YOU TELL ME!" look.

Smart arse!

After taking my own pulse and practice my speed-yoga. My eyes running amok over Nizam and the ventilator trying to fit the jigsaw puzzle together. Blood soaking his bedsheet turning it into dark crimson shade (nice colour hmm.. D'Oh stop it!!)

"...well Holmes, it looks like most of the blood came from his mouth and his breathing tube. So the bleeding must have originated from his own lung, huh the clotting system is screwed big time. And a blood clot must have blocked the tube hence the ventilator can't generate enough pressure to ventilate him - Eureka!"

I felt like patting myself on the head and say Good Boy! --> Now do something about it!!

I grabbed a laryngoscope and shoved it into his mouth. Sure enough a blob of blood clot was blocking the end of the tube and to make it worse the tube was at the tip of the vocal cord which is as good as being dislodged.

A double whopper! We gotta do something fast or he's gonna die!

"Quick get me sux 100mg " I need to paralyse this boy again before i can re-intubate him.

It took 4 people to hold him down as he was coughing up blood and restless at the same time. I wait until the paralytic drug kicked into action before I use the scope again to look inside his throat but my view was blocked by a pool of blood hiding the vocal cord.

PSSSRFTTT!! -- the suction catheter screamed like a burst old tyre.

BINGO! The enemy was in sight. I changed the breathing tube in one swift motion. His heart rate suddenly dropped to 30/min.

"Quick someone start CPR!"

Nora 'the feisty 90kg' Intan, a very reliable staff nurse jumped into action and start pumped away the boy's chest with all her might. Cracking noise of adrenaline & atropine ampoules being broken filled the night.

3 minutes passed...

"We got a rhythm...!" someone yelled almost sounded like heaven!

I'm so overjoyed that I almost yelled "Do the hustle!" duh da duh da duh da duh duh da!!

That night we all stayed next to his bed correcting his clotting problem like nothing else matter. True enough, that night nothing else did matter.

*****

2 weeks later a smart-looking young man on a wheelchair accompanied by his parents visited our ICU. He brought some pulut kuning for the staff.

From a distant I knew right away that it was him.

We almost lost him that night...
... and boy! That was a close one.