A Breathtaking Moment in Pediatrics ER

Assalamualaikum

Waahh lamanya baru menulis semula!! Dalam banyak2 rotation kan, round pediatrics ni lah yang paling busyyy sekali pernah aku rasa. Cuba korang bayangkan dalam masa seminggu tu ada sehari je cuti then cuti tu korang ambil extra class pulak?? Meaning I'm goin' cray-cray right now. I miss ol time.

Anyhoo.. dalam jadual tiap2 minggu kena datang ER sebab nak kena sign paper. ada markah tau uolls. nak taknak datang je lah. tapi best actually sbb dapat tgk budak2 comel termasuk resident2 yg kacak..errkk???

Haa ni lah dia kena minta sign doctor tiap2 minggu. 
Kerja aku dengan kawan2 mintak siiiiign je.hehe.

Tapi dalam banyak2 minggu tu, semalam lah aku betul2 breathless. sebab apa? Ada sorang baby ni (umur dia dalam 6-8 bulan) menghidap penyakit Farber Disease atau Lysosomal Storage Disease.

This disease is EXTREMELY RARE!! kira beruntung lah dapat tengok kes ni. So doctor kitorang time tu    (Dr. Moniem) bagitaw yg bayi tu kena pneumonia. Bila buat examination dekat chest dia penuh dengan pleural effusion. And if you try to touch the baby, he's not moving at all! Lepas Dr. Moniem explain pasal baby tu then kitorang pegi tengok kes lain pulak.( a 10 years old boy, with croup! ).

Tak lama lepas tu kitorang masuk Intermediate Care Unit. Jumpa balik baby yang tadi. Kali ni condition dia makin teruk. Sebab complicated by septicemia! Aku dah cuak time tuh sebab baby tu langsung tak gerak. At first, ada sorang resident ni attempt buat Endotracheal Intubation but failed and the baby's going into respiratory failure so Dr. Moniem buat CPR. Dalam kepala aku time tu "memang takde harapan lah baby ni" , tapi baby tu kuat. Second attempt buat intubate, alhamdulillah.. dapat pun. "Check breath sound! Is it equal?" Dr. Moniem said. One of the resident pegi check "ok". Then kena pasang mechanical ventilator untuk bantu respiration dia.

Now, tengok oxygen saturation, my friend said if its 92 then it's gonna be ok. Aku punya lah tengok rendah semacam O2 sat dia 40,43,45,50,67,69,73,80,87,93.....  fewh! Finally! Stabil pun... Bukan setakat baby tu yang tak boleh bernafas, haa aku ni yang tengok pun sudah kaku di belakang. Not long after that his O2 sat drop again! Then the resident removed his ventilator and use ambu bag instead. Diorang betul kan something (maybe ventilator tu pasang tak betol kot?) then baby tu stabil balik. Senaaang rasa hatiku.

But what makes me sad is when Dr. Moniem said this baby will eventually die because his condition is really severe. Kalau ikut dalam buku pun most children with this disease die by age 2 usually from lung disease (dalam kes ni? pneumonia). But this baby was strong! He fought for his life and didn't give up! Even when there's no hope.

Gambar sekadar hiasan. Lebih kurang mcm ni lah masa buat intubation tu.

So lepas ni kena belajar betul2 skill buat intubation tu bukan senang. They said "Practice makes perfect" . And what's really important here is EXPERIENCE! That's all for now.


Thanks for reading this entry.