A Toxic Night

Shift started at 11pm 'til 7am when one of my patient, Mr. X, suddenly groaned into fire like reaching the edge of his breath.

I had the most exhilarating shift that I have ever experienced as if my mind thinking of another dimension.

Of course, everything should be noted in the chart. So here how it goes on my fdar charting. I was able to come up with 3 problems which made my shift extended.

F=Hemoptysis (4:30AM) (my shift would have been benign for all sake)

D= (+) hemoptysis, 300 cc blood

= c O2 via NC @ 6LPM

= c IVF patent and infusing well

A= ice cubes given orally (this is to stop bleeding orally)

= Tranexamic 2 grams given as ordered (this is an anti-fibrinolytic drug)

= referred to Dr. blabla; seen and examined

R= still c hemop

at the same time, patient experienced...

F= Difficulty of breathing

D= c O2 sat=81% BP=90/70 PR=120 RR=34 (this is already moderate hypoxemia i guess)

= gasping for breath

= use of accessory muscles

A= placed on high back rest

= seen and examined by Dr. blabla

Mr. X was still in distress...

F=Desaturation

D= O2 sat=41% BP= 90/60 PR=125 RR RR=28 (this is already severe hypoxemia, of course)

A= Code Blue activated (i believe it was a silent code, not like in USA its completely announced)

= Dr. blabla explained and consented for intubation

= Diazepam 5mg IV given as ordered prior intubation

= Intubation done by Dr. blabla

= ET inserted, size 8 @ level 22

= ambubagging and suctioning done while waiting for mech. vent. (this made me very exhausted, thanks God)

= foley cath (Fr. 16) inserted aseptically

= continuous monitoring of V/S done

R= responsive to calls (thanks God he can hear me singing, LOL)

= latest V/S: BP=140/70 O2 sat=96% PR=110 RR=28

= endorsed to 7-3 shift for continuity of care

that's how my charting ended in a concise and detailed manner.

will wait for another exciting shift to get my life miserable and exhausted...hehe lol

Puntos para recordar

Si se le dará a 10 pacientes en cada turno, qué hará?

He aquí cómo usted puede manejar mayor parte de las tablillas.

1. Después de la aprobación, beber mucha agua para compensar los electrolitos utilizados desde su cuerpo al hacer rondas.

2. Planear antes de preparar toneladas de meds.

3. Ore para que las cosas funcionan perfectamente hecho.

Primer Gráfico

I had a patient diagnosed with Foreign Body Aspiration secondary to fuse pin. Prior to admission, he coughed out bloody sputum with minimal DOB. I can't picture how was it look like when you have this kind of thing beneath the main room air of your body. Bronchoscopy done but failed to get this thing off. Surgical instead is the one last resort which is known as Thoracotomy. Hope this patient will get through this.