INDEXING TITLE: CLEYSON’s Medical Anecdotal Report (05-03)

 MAR TITLE:  Resuscitation

 Date of Medical Observation:  April 9, 2005

 Narration

             I was manning the ER alone while the rest of my co-residents were delegated other tasks outside of trauma when 2 patients were brought in. Both were young adult males of medium built, both victims of a stabbing incident. But the similarities between the two end there. The first patient was a 25 year old male with no signs of life in him. The second patient, on the other hand, was a 24 year old male who presented with shallow breathing, tachypneic with a respiratory rate of 39 cpm, tachycardic at a rate of 120 bpm, and at the verge of impending shock with BP of 80/50

            Together with the clerks and intern, we went to both patients and surveyed their injury. After my first assessment, I gave an order to my intern and clerk to insert an IV line and O₂ support be given. I then instinctively went to the 2^nd patient, readily intubated him, and initiated CPR. Within a few minutes my co-residents came and helped me resuscitate both patients. The 2^nd patient was immediately wheeled in to the operating room for exploratory laparotomy while the 1^st patient, unfortunately, expired.

 Insights (Physical, Psychosocial, Ethical) (Discovery, Stimulus, Reinforcements)

             In managing trauma patients, the first thing to do is to perform your primary survey, to check on the injuries of your patients and categorized them as to the severity of the injury. The minor injuries are usually treated last. For some, the philosophy is to treat those who have a chance to live and leave those who figuratively have one leg into the burial ground. Crude as it is, this scenario indeed occurs in desperate times. However, this type of prioritization cannot be applied at this particular instance for reasons that there are enough resources within the hospital and there is adequate manpower to attend to both patients.

             In death through violence, usually the relatives are face with the shock of losing a loved one and cruel fact that the death was caused by another human being. During these times, they relatives are very vulnerable. They will blame anyone. That is why, even though we know that the first victim was clinically dead, we could not just pronounce him dead without even doing something. We might be caught in between and be blamed for the death of the patient and be accused of letting the patient die. In this situation, we were advice to at least do cardiac compression and ambubagging.