This date marks as one of the saddest moment of my life as a nurse to date.
The 12 hour shift at the St. Francis Ward (aka Dengue Ward)/ Annex was not toxic. Well, as compared to the General Ward where all our doctors were there reviving a patient who has dengue. Oh gawd. Dengue. Intubation and all. Epinephrine? That case of the patient could be that worse having that scenario. Tsk..
It was hard to stare at the patient's folks wailing. Crying. I wondered who's child could he be.
Later in the afternoon, an hour before my off--I was asked if I'd be willing to be an SP for that patient. I couldn't say NO to our chief nurse. I wanted to say no and about to say no (because it would turn out that I'll be on duty for another 12 hours, making me alert, alive and enthusiastic for the whole 24 hours!) when a lady, obviously post crying, told me to stay with her child and be on guard--as a nurse. A private one. Or an SP.
I know this lady, but I and it took me a while to remember! My aunt's co-teacher, a dear friend of hers. I didn't know she's the mother--he is their ONLY child. HOW CAN I SAY NO? Alright. They said he was getting stable--a whole lot better hours ago.
The patient is just 6 y.o. Intubated, ambu-bagging ongoing. GCS 3 with lots of IV fluids and drips and an NGT to drain. The cardiac rate wa good but teh BP was 40 palpatory. (Oh.draining to coffee ground like discharges--bleeding. Yes.) I was so sad, so touched. Hearing the parents words, seeing the family cry. I PRAYED.
I was so tired and sleepy and wanted to go home but I can't. i shouldn't. I didn't let my SELFISHNESS win.
I started monitoring him from 7pm, ambu bagging, neuro VS monitoring--helping carry out doctor's orders. The only vital signs that was not stable was his BP--still at 40 palpatory. I did my best to show my care, after all, I know his parents. I urged his grand parents to talk to him, to keep talking because he can still hear them eventhough he is in coma. That was hard.
His blood is hemolysing. Blood oozed on his previous IV sites and fresh blood is draining in his NGT. He was getting worse. I hate this. I hate this. Our doctor asked his mother to request FFP for transfusion. I injected Vit K.
Around 10:30pm. I cant appreciate his cardiac rate anymore! Even his BP. He became pale. Gawd. I called our staff and got the ECG machine at the ER. The family members were rushing in, crying, bothered and all.
Epinephrine. CPR. What a scene.The ECG was printing asystole--flat line.Almost a flat line. Very sad. I was teary-eyed while we were reviving him. His father told me to stop it--to just let go. But I didn't stop until the 2nd or 3rd time I was told to stop the ambu-bagging. That was it. God bless him. I closed my eyes and prayed.
It was very hard for the family--they did their best and so as we, the medical team.
I tried to control my emotions.I was teary eyed. It was the saddest moment I have witnessed. An only child, lively and very caring passed away because of dengue. The most severe one. Dengue Shock Syndrome.
I HATE DENGUE. I LOATHE IT.
Dengue shock syndrome: A syndrome due to the dengue virus that tends to affect children under 10, causing abdominal pain, hemorrhage (bleeding) and circulatory collapse (shock). Known also as dengue hemorrhagic fever (DHF), it starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. Shock occurs after 2 to 6 days with sudden collapse, cool clammy extremities, weak thready pulse, and blueness around the mouth (circumoral cyanosis). There is bleeding with easy bruising, blood spots in the skin (petechiae), spitting up blood (hematemesis), blood in the stool (melena), bleeding gums and nosebleeds (epistaxis). Pneumonia and heart inflammation (myocarditis) may be present. The mortality is appreciable ranging from 6 to 30%. Most deaths occur in children. Infants under a year of age are especially at risk of death. It is also called Philippine or Southeast Asian hemorrhagic fever.
Source: http://www.medterms.com/script/main/art.asp?articlekey=6628
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