Prepare for a heart wrenching, tear-jerking and heart breaking story. This took place 3 weeks ago in a real setting. I actually wrote a blog about this because I cannot seemed to keep all the emotions within myself. Today, I want to share with you again an event that broke my heart.
Amidst of what we thought as a regular day in PACU(Post Anesthesia Care Unit) erupted a sudden announcement of "code blue OR 3". I stopped midway of administering pain reliever to my post op patient. Everything went into a slow motion and I thought I was hallucinating the first time. Then, a second announcement confirmed my thoughts, I halted and look around for possible help. We anesthesia nurses are the first responder of a code that happens in the OR. I stopped and look around, I saw everyone was also in shock. When no one dared to move, I ran as fast as I could to the OR theater.
Apparently, it was an ongoing pericardial window. A man was lying in the OR table, pale, limp and out of life. The cardiac monitor reflected a flat line ECG. The blood pressure was continuously dropping down. I panicked for a little while and was trying to steer clear myself of any unnecessary thoughts. Breathe in, breathe out. I was chanting the same mantra for few seconds. When realization dawned upon me, I hurriedly opened the E-cart with my trembling hands. The team, was doing respective jobs to resuscitate the patients. The surgeons on the other hand were busy troubleshooting the heart. It was said that they unintentionally punctured the heart leading it to bleed profusely thus caused such fiasco.
The anesthesiologist was the code leader at that moment instructing us what to do. The thing is, a CPR couldn't be performed because it's an open heart surgery. A manual stimulation of the heart was done through heart massage. Defibrillation was also impossible because it needed a paddle which was not available in the OR complex. While I, was medicating the patient, administering Epinephrine to help stimulate the heart. After a cycle of resuscitation process no improvement was noted. Still, the patient was on asystole(flat line).
The code went on for several minutes. Fluids were infused, bloods were transfused. Epinephrine, amiodarone were administered to fire up impulses and restart the heart. It was a rush of adrenaline for all of us. It took 45 minutes before the patient was revived. His heart rate went from 0 to 80 beats per minute, his blood pressure went up to a systolic bp of 120mmhg. We took a deep breath. Thankfully, we did it! I said to myself. The operation was then continued and the patient was for ICU admission.
I went back to my unit, I was panting and breathing heavily. I saw the relatives in the waiting area, waiting for a news of their loved one. I pry for a little bit of detail about the patient. He was 19 years old and was studying college. He was diagnosed with heart tumor. He was reluctant to undergo operation at first but when he had periods of difficulty in breathing he decided to have it operated. There were too many people outside the recovery room and all of them were his significant others. They were teary eyed and his mother was sobbing. The surgeon and the anesthesiologist came to explain to them what happened. I heard the mother saying while crying "please doc, do everything for my son, let him live". Upon hearing those words, my heart broke and I nearly cry. He was too young to die, I thought.
Few minutes passed, I was busy nursing my patient and compensating for my delayed dues, I heard again the announcement. He's on code again. I heaved a deep sigh and silently prayed that he'll survive. The next code, I didn't get to help them out because I already had my own patients and they seem to be doing fine. Still, a resuscitation process was done. They defibrillate the patient because they were able to find a paddle and giving him certain joules. I went in the OR to see what was happening. To my dismay, the doctors and nurses were already sitting down. I ask them what happened and they shook their head. With the disappointment etched on their faces I already knew that the patient didn't make it.
My heart was so heavy, and my throat was aching. I saw him, in the OR table, lifeless. I was holding my tears back because I didn't want to cry. Then I went to the recovery room and the door to the waiting area was largely opened. The doctors again went to the relatives and was about to deliver the bad news. Right then and there, an agonizing cry erupted. His mother went hysterical. His girlfriend went ballistic. All of them were sobbing. While I, couldn't hold back my tears anymore and I cried silently. Sympathizing them in my own ways because if went with them and cried it would be a little awkward right? Yeah, so in my own self I was mourning, and I didn't even know why it affected me so much.