Friday, September 4, 2009, 9:23 PM
Wednesday, at around 7 or 8 in the morning, this awake but unresponsive 8-month old boy was rushed to the ER by his mother. When the mother was asked what happened, she alleged that her child had been expelling watery stool since the night before the admission. The doctor on duty, after a quick assessment, commanded the staff to administer oxygen and intravenous fluid STAT. Everyone was on a rush for the child was critical. The oxygen was already running but the nurses were having problems locating a vein needed for the administration of the IV fluid. The patient's case was diarrhea and it's very important to replace the electrolytes the boy had lost through frequent defecation. Three nurses together with our clinical instructor, Ms. Oropesa, were minding each extremity, trying their luck to find just this one vein that will help this poor child survive. The patient had small veins which were very hard to visualize.
Everyone was skeptical about what the mother had said about how long her son had been experiencing diarrhea so one volunteer nurse asked her again to make sure she was telling the truth. Her answer this time was different from the first. "Tatlong araw na po," was what she admitted. We weren't actually sure why the mother had to lie about her son's condition. Though the nurses were obviously irritated, they remained calm and just asked the mother to leave the area while they continue finding a vein. “Pray to God to give us the vein we need,” Ms. Oropesa said. I prayed silently.
I was one of the four members of our group assigned at the treatment area. Sir Sam, the head nurse of the ER, asked me to wear gloves and suction the secretions of the patient, so I donned my gloves and did what he asked me to do. Then he announced that the patient needed a nasogastric tube to remove the air that was causing the distention of his abdomen. Since I was wearing gloves, he also asked me to do the procedure. Though it was my first time, the trust I had seen from Sir Sam and Ms. Oropesa's eyes had given me the courage to do it. The thought of helping the child also aided my nervousness.
Minutes passed, episodes of seizures arose, and numerous needle insertions were done, still the IV fluid was still not connected. I was still on the side of the patient suctioning once in a while. It was a stoke of luck that the oxygenation of the child was supported immediately so the child's condition had gone better; he was already crying as his response to the pain caused by the needles, a good sign of an improved level of consciousness. But the main problem was still unsolved.
After a total of 33 attempts of IV catheter insertion, the doctor ordered a “cut-down”, a process of cutting through the skin to find a vein where a narrow tube will directly be inserted to facilitate the administration of the IV fluid. I carried the child on our way to the ER’s operating room. To make it short, the cut-down was unsuccessful after 3 hours because even the narrowest tube the ER had didn't fit right through the child's vein. After closing him up, one nurse looked for a vein in the child's head and tried to insert another catheter. We were relieved that it was successful so one of my group mate set the IV to fast drip right away. When the child was finally stable the doctor ordered to admit the child to the Pediatric Ward.
Feeling so happy and proud that that tough child survived those critical minutes of his life, I, together with four of my group mates accompanied him and his mother to the ward. We endorsed him to the nurses on duty then we left. We were back to the ER and routines were carried on as usual.
The child died, Ms. Oropesa informed us minutes before our 6pm dismissal. We didn't know what caused his death but we were all saddened about it. Up until today the moment I had with the child during that morning of Wednesday is still clear to me. I just hope that what happened served as a lesson to the parents of that child to take care of their remaining children and consider the health of each member of the family as their priority.
To YOU: You are now resting in peace. You are now in a land free of pain.
You have shown us how tough you were and we are proud of you. I am proud of you.