Earlier this May, my colleagues and i were in the ICU having a tute when the doors swung open and an old man was pushed in on a bed with a Dr poised on top of his chest giving cardiac compressions.
That was the end of our tute. The patient was quickly hooked up to the ECG and various other machines, intubated and ventilated with a bag. The Drs were pumping adrenaline into him like there was no tomorrow.
We all hung around, trying to be unobtrusive, watching the different people take turns hopping up onto the bed to give him cardiac compressions. I was impressed that those cardiac compressions were so good that they were creating electrical impulses that could be picked up by the ECG.
By 15mins, the various Drs and nurses were tiring out and someone asked if we wanted to have a go at doing CPR.
Woohoo! Real life hands on experience! Not just practicing on a mannequin with that artificial click with each compression.
When it was my turn, i clumsily climbed onto the bed. Scared that the time i've wasted on that horrible transition was critical, i pressed down as hard and as fast as i could on the patient's chest. Intermittently rechecking that the position of my hands were right. It wasn't hard to tell because there was a dent where the other medical personnel had been pushing down on.
It was then that i looked upon the patient's face. His eyes were semi-open, looking at me and yet not seeing. Mouth slightly ajar with the endotracheal tube sticking out and taped to his face. Saliva slowly accumulating and suctioned away by my tutor who was in charge of giving him breaths through a bag.
No consciousness, no comprehension, no self-generated initiative to live, probably no brain waves as well. Yet he wasn't dead. He was still warm to touch. Warmer than my clammy hands. What is this state of limbo?
A colleague of mine took over from me after 2 minutes. I felt like i had spent an eternity looking at the patient's face. Not long after, he started generating a weak pulse. There was a collective sigh of relief and we med students left knowing that there would be no more action for us today.
Unfortunately, the patient couldn't sustain a pulse and eventually passed away after a further 30mins of advanced life support.
It was comforting to know that the team did everything they could for a protracted amount of time despite the fact that the old man had multiple end stage comorbidities and a very slight chance of survival. I hope his family knew that too.
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