Monday, March 23, 2009

My first death..

My 2nd oncall proved to be disastrous indeed. In the middle of the night, at about 0100H, i was reviewing a new patient that had just come in from the emergency department. She was stable, and planned to have wound debridement done the next day. Next to her , was an old patient to the ward. She was cringing in pain, murmuring to herself that the pain was intolerable and felt it was best to die. SHe had uncontrolled diabetes with hip disarticulation already done (it was secondary to ascending infection of her leg).

She was complaining of abdominal pain and wanted to vomit. I immediately caught hold of kidney dish that was stashed near her. Upon seconds, she was profusely vomiting - it was dark red in color. I was in red alert, this was unmistakingly blood. She vomited one kidney dish full of blood and continued to have abdominal pain.

I checked her glasgow comma scale, in which proved to be full. No anemic symptoms - no symp-toms and signs of heart failure. Her vital signs were stable. No hypovolemia, good pulse volume. Her lungs were clear, her oxygen saturation was normal.
Per abdomen, it was soft, and nontenderr. No guarding.

Per rectal examintion proved no malaena.

I rushed to my Medical officer and had alerted the staff nurse to keep an eye on her while i get assistance.

We immediately referred to surgical department and within minutes they rushed to they patient. Fortunately that night, the surgical referral team were such nice people. We all attended the patient, and urgent endoscopy was decided upon.

urgent endoscopy proved that the diagnosis was from the upper gastrointestinl tract..but, they were still unsure of where the exact location was.

Thus , the patient was taken back at the ward and she was kept under surveillance.

2 days after the incident, i had wondered where the patient had been,..I was informed the day before that she was taken to the surgical department for further management.

Alas, to my disbelief, I was informed that the patient had died in ICU . She had developed cardiac arrest. Resuscitation had failed.

This is my first time having a patient died. I've never had any of patients having such critical episode before.

I dont know how to say it actually. It's not the same as it had been when you were student and "having to take charge' of the ptient per se. But this time around , you would have to be vigilant and know how to handle acute emergencies.

I dont know whether it was my fault. Whether if i was more vigilant towards the patient, the outcome would have been different.

I never got to apologize to the patient , if i had done anything cross towards her.

THis is the things that I have to face now..this is not just WORK per se..THis is about taking care of people..this is called responsibility..

Sesungguhnya Kepada Allah jua kita Kembali..

We are never in control of situation, but we are responsible for our just action.
In the akhirah later, we would all be questioned what we have done..have we done the things that should be done?

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