Whew! I'm glad m post duty now!

After 2 duties in Boracay, I'm back as a reliever resident in Ospital ng Muntinlupa. Scary. It's been a while since I did in-patient management. Fluids and electrolyte management seems like rigging a carburator to me. So, the first thing I did was borrowing a copy of Pocket Pedia from the post duty resident. Great book! Too bad its not available now.

Anyway, the first 8 hours of my duty was so-so: an IV line here, chart ordering there. Benign stuff. I was also the catcher in the nursery. I resuscitated 3 newborns on that half of my duty. All of them are spontaneously born so I don't need a lot of skills AND anxiety to do that. Not so toxic. Not at all.

But wait! Before I leave the next morning, everything went so fast. I had 3 admissions (all of them need a new Hx and PE) and my PICU patient is crashing while m waiting for 2 pregnant patients to give birth! To top it all, I need to do my endorsements before 9 am.

My 28-weeker PICU patient is the worst ever! He had several episodes of O2 desaturation last night. We transferred him to an O2 mask from an O2 hood to improve his O2 sats. It went up to 98-99 but he is still having chest retractions. His vitals are stable but I was wary of the chest retractions. It was way beyond normal. And I had a bad feeling about it.

And true enough, his sats dropped to 50s the next morning. I have no choice but to intubate the poor baby. In all honesty, I never intubated a preterm baby in my whole life. I was anxious but if I don't do anything, this poor baby will die before my eyes. After a few minutes, I was standing there with the 2.5 ET tube in my hand and the laryngoscope in the other. I took a long breath and inserted it between the glottis I exposed with the laryngoscope. Breath sounds were not equal so I pulled it to level 7. Both lungs expanding, equal breath sounds...whew.

But it doesn'e end there. The baby was still crashing. I gave him two doses of epinephrine and primed the parents that the prognosis is not good. His vitals were stable when I left him but all I can do is hope for the best for that baby. Poor guy.