Summer Nightfalls (Completed) [R18]

4 : Blood Urea Nitrogen

Ivana

He's back to ward. True to what he said, bumalik nga siya sa ward. And he's having his OR now.

" Sunod sunod ang ginagawang surgeries sa OR ngayon. Puro neuro OR pa daw. Bumalik na naman kase sa ward si Doc Montenegro kaya tambak ang OR" Chismis sa akin ni Chin. Napatawa na lamang ako sa sinabi niya.

There's nothing new to it.

We were busy talking when I've got an admission. A familiar patient got admitted. Kilala ko ang pasyenteng naadmit dahil lola iyon ni Luigi. She was wheeled in via stretcher.

I immediately took her chart and read her case. CVD infarct, bleeding. Medications were started at the ER. The patient is unconcious, GCS 10. Stand by intubation.

I've readied the ICU and assisted in wheeling the patient to the ICU.

" Goodmorning po ma'am. Endorsing to you patient Marites Montenegro, 87 years old female patient. Came in due to severe body weakness three hours prior to admission followed by sudden unconsciousness an hour prior to admission hence brought to the ER. Patient was seen by Doctor Villa at the ER and was endorsed to Dr. Montenegro. Dr. Montenegro was notified of patient's admission and admitting treatments. Rapid test negative. Mannitol 100 cc q 8 hours, started. Ceftriaxone skin test due 10:30 AM. NGT inserted, due medication started at the ER, ma'am. IFC initial output drained was 250 cc, bloody in appearance. To hook to oxygen via face mask at 3-4 Liters per minute to maintain an 02 saturation of 95-100%. Continue na lang din po ng monitoring sa output. Doctor Montenegro will come in an hour. Ongoing pa po iyung OR niya. Mukhang emergency OR po ang pasyente mamaya ma'am. Pupuntahan muna daw ni Doc Montenegro" Pag endorse sa akin nung nurse. I immediately hooked the patient to oxygen and cardiac monitor after receiving endorsement. Nagstand by intubation na din ako pagkatapos. I am aware that the patient is in critical condition.

" The patient was advised to remain at the ER by Dr. Villa but Dr. Montenegro insisted to admit the patient in the ward" Wika naman sa akin nung ER nurse na naghatid sa pasyente.

Inaayos ko palang iyung pasyente ng makita kong hindi maganda ang vital signs niya sa cardiac monitor. Ilang segundo lamang ay nakita kong nagcocode na ang pasyente. Napamura tuloy ako. I pressed the emergency buzzer then started my CPR.

" Please call the doctor on deck. My patient is having an arrest" Wika ko sa nurse na kakapasok lang sa ICU. She immediately responded. Isang nurse naman ang pumasok para maginject ng Epinephrine 1mg at maglagay ng cardiac board. The patient needs to be revived. I continued my first cycle of CPR then switched with Mike who just came in.

Doctor Villa came but still the patient is not responding. I assisted in intubation.

Nakalimang epinephrine na kami ngunit ayaw parin. Amiodarone IV bolus was given but still, unresponsive. Nawawalan na ako ng pag asa ngunit hindi ko sinukuan ang pasyente.

" Come on please" Bulong ko.

Flat line still.

I muttered a curse in my mind.

Saktong dumating naman si Luigi. He was still on his scrubs when he came.

We weren't able to revive the patient on bed. Flat line parin ng dumating si Luigi. He was looking at me and I wasn't able to look at him directly. Ayoko siyang tignan.

Alam kong maya maya pa ay darating na din si Dr. Vince Montenegro at ang kaniyang asawa pati na ang mga kapatid ni Luigi.

Lifeless on bed, I saw how Luigi respectfully accepted the death of his grandmother without saying a word.