an eventful week

my colleague went on leave for a whole week, so i stood-in for him during the absence. it was very busy, with a couple of near-mishaps, so in a way, i'm glad he'll be back tomorrow.

near-mishap #1:

cordarone - used to slow down the heart rate when it gets too fast, eg. atrial fibrillation. when the heart beats too rapidly, eg over 140 per minute, its pumping action becomes less effective. (note: so if someone told you that you make his/her heart race, you might not actually be doing this person a favour!!) this is potent stuff, so it has to be given as a slow infusion. this patient has amiodarone running in, but infusion set WASN'T labelled!! the nurse gave the excuse that she had been too busy, but seriously, it would have been catastrophic had the infusion rate been unintentionally stepped up. the patient's heart could have literally been stopped dead in its track. fortunately, the oversight was discovered on time.

near-mishap #2:

dormicum - used commonly for sedation & an overdose could render a person unconscious. i asked the nurse to prepare this as i explained to the patient's relatives what i had planned to do. in the midst of this, the nurse told me that the patient's blood pressure was dropping & he was getting drowsy. this nurse, recruited from a foreign country to fill in the vacancies arising from our local nurses seeking greener pastures elsewhere, had apparently misunderstood me & thought i instructed her to prepare AND administer dormicum to the patient, which she diligently did as i was explaining to the relatives.

after hurriedly excusing myself from the relatives, i had to immediately administer oxygen & assist the patient's breathing, & had the situation under control shortly after. but not before explicitly admonishing the errant nurse on the use of common sense - NEVER administer sedatives without preparing for the expected unconsciousness.

patient #3:

this was a cute 5-month-old child who fell off a sofa & had to undergo brain surgery. this is just me - i always have a soft spot for patients with biblical names, esp children, & i often wonder how the Lord will lead them. the surgery was a success, & i hope this child will claim the promise of his namesake:
The LORD was with Samuel as he grew up, and he let none of his words fall to the ground. 1 sam 3:19

despite getting caught up in work, i'm glad i still managed to bond with the boy:

i went on a lantern-walk with him around the neighbourhood & ....

....he helped me wash the car.

looking back, it was a good week - eventful yet balanced.