What Happened in ICU?
It was quite a tense day when I was working in the MICU (Medical ICU) few days back. I think not just that day it was hectic. Almost everytime I was there, I have to be more alert and conscious with the surrounding. The patients were critically ill and need strict monitoring of their health progress.
Sometimes, when there are no new admission, we consider it as a lucky day. We just have to manage the present patients only, majority of them are already stable. If there are new admission on the other hand, I consider it as an opportunity to see how the seniors are managing their patient.
I remembered one last time when there was a new patient being transfered to ICU from casualty ward. He was in his 40s, got admitted due to history of convulsion in the morning. The seniors in-charge rushed immediately to him and started to intubate him. Before that, an IV line was set up so that we could give appropriate medication stat, as soon as possibl to minimise the risks.
He was intubated by our senior. It was a common but tough procedure in ICU. It is an emergency procedure and has to be done so quick to save the patient’s life. It was seriously a nerve-wracking procedure I tell you. Within a short period of time, you have to insert the endotracheal tube (ETT) through the opening of the vocal cord which needs an ‘eagle eye’ to see the opening.
One should be very confident and have a strong will to do that kind of procedure.
After that, we put the central line to the patient. I take the first prick after palpating the right carotid artery, under senior’s guidance. No blood was coming out. Second prick was attempted, but still no dark red blood was seen in the syringe. Then the senior did the prick, while we the interns helped him to put the guide wire and the stitches.
Foley’s catheter was applied to assist the urination as he lost the bladder control.
Blood pressure was taken, and it was so low, not satisfactory. This means that we have to put him under strict observation. BP is one of the important indicator of his health status.
That is one of the situation that we encountered in the ICU. The patients were so critical in such a way that they need to be managed urgently within a limited period of time. Every second counts so much. It decides the life and death. The survival of the patients.
This is the real world. This is sometimes a bit different from what is written in the text book.
To handle the emergency patient, it requires experienced person who have seen and manage lots of cases.
Some say, if you want to be a competent medical practitioner, go to casualty and get the experience there. I think, this is quite true.
p/s : The above patient cannot survive eventhough treatment was given. I was being told by senior when I was there to see his progress on the next day. He is a Muslim. My fellow Muslim brothers and sisters, let’s pray for him so that Allah may forgive him for any sins committed and grant him the best place there.