Day 3 : 18th May 2016
My colleagues and I were managed to listen to the passing report from night duty staff nurses. So there are only 3 patients in total. One patient to transfer out to the medical ward. Whereby one patient to have a CT Scan (Computerized Tomography Scan) to RIPASH as the CT scan machine in SSBH is still under maintenance.
So we have to prepare the transport system (ambulance), the sending off forms, the items that are required in case of emergency such as the Automated External Defibrillators (AED), the oxygen tank. The patient is ready sitting on the wheelchair. Then we went to the ground floor as the ambulance was awaiting us.
After sending off the patient, we went back to the unit and we had a long briefing on the drugs names and its indication with the Sister. He surely has a lot of knowledge on the medications' indication. We
surely learned a lot. The drugs that we discussed are mostly and
commonly used in the ICU. Oh yeah, the Sister showed us about the
machines that are very useful such us the ventilation machine, the
blanket warmer, the cold freezer that are used to store the
medication that are must keep between 2 degree Celcius to 8 degree
Celcius.
So
he gave us a situation that what if there is no electricity in the
whole building of hospital, what action shall we take? First, we have
to find a cool box then get few ice packs and a thermometer. A
thermometer is very useful and very vital as we have to keep the
temperature within 2 to 8 degree Celcius. If the temperature is not
within the range, the medications will be damaged and very harmful to
use.
Then
he told us about the importance of document the usage of Dangerous
Drugs Act. Usually the DDA will be kept in a safe box that are always
be locked unless the patient is prescribed by the doctor. We have to
write down the quantity left, quantity used, the person administered,
time, date and every things that are required to fill. As this is to
ensure the usage that has been administered.
After
for about few hours later, around 12.05 noon, we received a patient
from the medical ward. The patient has low blood pressure and slow
pulse rate. Then we checked his temperature and get his glucose
level. The temperature cannot be read as he got a very low
temperature. My colleagues did the Electrocardiogram (ECG). All of
sudden his BP got very low, for about 55/40 at around 12.15 pm. The
patient got bradycardia at the moment.
Fortunately
there were cardiac arrest team are around in the unit. We get the
emergency trolley and everyone got our roles. We as a student are to
observe and jot down any changes or any words that are important by
the doctors, for example about the medication that should be given.
Then
a doctor did the endotracheal from the mouth, the staff nurses did
all the salines, prepare the drugs and assist the doctors. Then we
managed to observed and saw how the doctor did the CVP Line, the
Central Vein Puncture. The doctor did ultrasound beforehand.
Adrenaline, atropine, dopamine, dobutamine.
After
all this episode, we insert the urine catheter to prevent urine
retention and before that we gave him a blanket warmer to warm the
patient. Then we got his urine for sample to check any risk of
infection.
This
is the first time ever encountered and witnessed an emergency case
and sort of live-show for us to see the doctor inserted this and
that.
Bradycardia
is an abnormally slow heart rate of less than 60 beats per minute. A
normal heartbeat is between 60 and 100 beats per minute.
Okay,
that's all for today episode.
Love,
D.