We had another code at Ortho Ward today.
Being in a department where a code is a relatively uncommon sight, we were all at our toes to attend to our patient immediately. A code is never a pleasant event (who wants to see a patient dying, for crying out loud), and I’m not saying that I particularly enjoy being in one, but I was amazed (even proud) of the way our team did our thing today. The residents were strong and steadfast, the nurses efficient and reliable, the interns and we the clerks quick to respond and ready.
It was unfortunate though that after the team’s resuscitative efforts our patient still eventually expired. The atmosphere at bedside was somber, but we still got to thank each other for the efficiency and dependability with which all of us attended to the urgent matter. I realized how much of an honor it was to be in my shoes, to be in the company of these competent and compassionate professionals who work with each other to provide quality health care to the underserved patients who need it the most.
On a sidenote, I got to break someone’s bones today, though not purposefully. The sound a broken rib makes when one does chest compressions will never be forgotten. Also I realized that ambu-bagging might even be more tiring than doing chest compressions itself.
It’s uncanny that for the first two codes I’ve taken part in, I always saw the patient through the course of their hospital stay. That’s in a service with a sixty-bed capacity, not including the Ortho consults in the ER in a given day. And I weren’t even decked to either of these patients once they got admitted into the wards.
EA was a forty-something patient who I first saw last Monday when I was on ER duty. He was admitted to the ER the previous day for a tibial fracture after falling from standing level. He also came in with generalized jaundice, and on history we found out that there was an alleged liver mass found on ultrasound performed at another hospital. He was also tachypneic, tachycardic and slightly febrile.
My perky intern (the same intern from my ward duty last Thursday) and I facilitated completion of his labs, and she tasked me to refer our patient to Medicine. Fortunately, the nice IM resident called up within an hour after I dropped the referral and he came to see the patient immediately. I shadowed him during the PE, where we found out that our patient had hepato- and splenomegaly, a sign of probable liver disease.
At this point we were considering a primary liver malignancy, and his fracture might have been a pathologic one secondary to bone metastases. We were also considering pneumonia. I insert a line for some meds, advised tepid sponge bath to abate the fever, and established rapport with the patient and his relatives in the process once I found out we spoke the same dialect.
EA then gets admitted to the wards supposedly for open reduction and internal fixation of his tibia. I saw to the patient yesterday and this morning, checking up on his condition, how he had already been stable for the past two days, how his fever and jaundice seemed to be resolving. And now for this to happen very suddenly; it’s unnerving. The fact that life is fleeting - one moment you’re just on your way to work and the next you find yourself being resuscitated until you expire - it’s a constant reminder that we should all be grateful for this life and not take it for granted, living it to the fullest and for the common good.
(PS. They signed it out as a pulmonary embolism. Sad.)