Wednesday, July 13, 2005
It Could Happen To Anybody #2
The boy was still groggy when I handed him over to the parents and the charge nurse, but he’s safe to return and I knew I had something else waiting, brewing in theatre SEVEN, and must help.
I rushed into the next theatre to find a young woman on the table. Tube in her throat, nose, left hand, right hand, and also out from between her legs. Surgeons rummaging through as they do normally.
Arterial systolic 60, pulse 140, adrenaline cassettes scattered opened about 6. All numbers were in the red on the monitor and she’s been through 6 cycles of cardiac arrest. We’re in debt with this lady.
She looked pale, dead and battered. Extremities blue from the vasoconstrictions. She had the hysterectomy earlier in the day on routine operation list, and that’s all I could gather from the scanty notes. Apparently, recovering well from the anaesthetics since been back on the ward B1.
Between then and her lying motionless on the table, she lost consciousness, lost her aiway control, warranting an anaesthetist intervention. That puzzled everybody.
Naturally I asked Kevin what happened. He was doing the air through the nasogastric tube test. The 3 surgeons anxiously waiting for the crafty diagnostic test,
a loud farting sound came out from the top, their eyes fenced on top of the masks showed excitement and they were right, the stomach had been perforated, popped.
Like a bunch of remotely controlled machines they immediately extended the hysterectomy incision up to the sternum and started stitching the hole.
Kevin backed off, staring into space and slowly sat down. He looked like he’s seen a ghost. I hurried to make sure he caught the chair on time. He buried his face in his hands.
Shit. That’s all I could hear him saying.
I felt my blood slowly draining. My throat choking, my tongue stuck to the roof of my palate, didn’t know what to say, where to begin. Could feel the mountain descending onto his shoulders, grey pregnant clouds homing onto view. Yes, big shit.
Due to the nature of the incident and potential lawsuit enveloping the whole event, it is not in my capacity to narrate exactly what happened. We could only learn from the mistakes. This I keep telling myself and those involved.
When we later took her to CT brain, she was already coning from the 40 minutes cardiac resuscitation, the brain had squashed itself through the base of the head and death is imminent.
That was the longest most uncomfortable silence ever. The humming from the doughnut of the CT scanner added beats to it.
Two things bothered me,
1) She’s so young and came in for a routine hysterectomy, what could possibly go wrong, people have their wombs out all the time. But things do happen. We sometimes forget a clause that comes with the statement ‘Being in a hospital’.
2) What would have happened had we not swapped? Would Kevin send Nick to get me to intubate the woman? Would the tube still get displaced into the oesophagus? Would I notice it and reinsert? Would I manage to tube her knowing now that she’s a nightmare intubation? Would I be that good? Better than him?
Should I count my lucky stars then? That's too selfish a thing to say. It’s awful what happened that night, awful, awful, awful and it’s every anaesthetist’s worst nightmare ever ever.
I just laid there supine staring at the ceiling for a good half hour before I could no longer fight my eyes at 5 in the morning.
All the time I kept thinking it could have been me, and not him. Woke up to an annoying phone call from an arrogant, selfish, simpleton who had no idea what a night I had but that is another matter and such a waste to blog about.
I rushed into the next theatre to find a young woman on the table. Tube in her throat, nose, left hand, right hand, and also out from between her legs. Surgeons rummaging through as they do normally.
Arterial systolic 60, pulse 140, adrenaline cassettes scattered opened about 6. All numbers were in the red on the monitor and she’s been through 6 cycles of cardiac arrest. We’re in debt with this lady.
She looked pale, dead and battered. Extremities blue from the vasoconstrictions. She had the hysterectomy earlier in the day on routine operation list, and that’s all I could gather from the scanty notes. Apparently, recovering well from the anaesthetics since been back on the ward B1.
Between then and her lying motionless on the table, she lost consciousness, lost her aiway control, warranting an anaesthetist intervention. That puzzled everybody.
Naturally I asked Kevin what happened. He was doing the air through the nasogastric tube test. The 3 surgeons anxiously waiting for the crafty diagnostic test,
a loud farting sound came out from the top, their eyes fenced on top of the masks showed excitement and they were right, the stomach had been perforated, popped.
Like a bunch of remotely controlled machines they immediately extended the hysterectomy incision up to the sternum and started stitching the hole.
Kevin backed off, staring into space and slowly sat down. He looked like he’s seen a ghost. I hurried to make sure he caught the chair on time. He buried his face in his hands.
Shit. That’s all I could hear him saying.
I felt my blood slowly draining. My throat choking, my tongue stuck to the roof of my palate, didn’t know what to say, where to begin. Could feel the mountain descending onto his shoulders, grey pregnant clouds homing onto view. Yes, big shit.
Due to the nature of the incident and potential lawsuit enveloping the whole event, it is not in my capacity to narrate exactly what happened. We could only learn from the mistakes. This I keep telling myself and those involved.
When we later took her to CT brain, she was already coning from the 40 minutes cardiac resuscitation, the brain had squashed itself through the base of the head and death is imminent.
That was the longest most uncomfortable silence ever. The humming from the doughnut of the CT scanner added beats to it.
Two things bothered me,
1) She’s so young and came in for a routine hysterectomy, what could possibly go wrong, people have their wombs out all the time. But things do happen. We sometimes forget a clause that comes with the statement ‘Being in a hospital’.
2) What would have happened had we not swapped? Would Kevin send Nick to get me to intubate the woman? Would the tube still get displaced into the oesophagus? Would I notice it and reinsert? Would I manage to tube her knowing now that she’s a nightmare intubation? Would I be that good? Better than him?
Should I count my lucky stars then? That's too selfish a thing to say. It’s awful what happened that night, awful, awful, awful and it’s every anaesthetist’s worst nightmare ever ever.
I just laid there supine staring at the ceiling for a good half hour before I could no longer fight my eyes at 5 in the morning.
All the time I kept thinking it could have been me, and not him. Woke up to an annoying phone call from an arrogant, selfish, simpleton who had no idea what a night I had but that is another matter and such a waste to blog about.
