did you best ?

 

I had this OHCA[Out of hospital cardiac arrest] case today… In the past, we use to classified it as DOA (death on arrival), however after multiple incidents and events the terms had changed and "DEATH" is no more mentioned. I remembered there was this medical bill which was complained by a family – the patient was tagged with the  diagnosis of death on arrival and the family had queried that since the patient is death why a long list of examination was performed… they refused to pay the bill…

I hate OHCA in the past – an exercise session for all the staff as we had to take turn performing chest compression. A tiring act especially late in the night, sleepy after many hours of stress. With the help of CPR machine, half of the time was staring over the monitor; a real boring act but more man power to spare for covering other patients in the ED.

The OHCA case was a severely obese male which had collapsed in front of his wife. We did the routine but no ROSC (return of spontaneous circulation ) was noted. 2 ventricular fibrillation episode was noted and two defibrillations were done. Most probable diagnosis was acute myocardial infarction and I knew nothing much could be done at the middle of the session though, I had to do my parts. After 35 mins of effort, I broke the news to the family and continued with the charting.

The wife had summoned me later and asked me what was the cause and I told her what I knew but she had asked one more question which made me felt uneasy – “ did you all did your best ? “

I answered, “of coz, we had used everything we could, you can see we had even used CPR machine which cost NT 400k….”, yet I knew the machine was the culprit which made the wife raised such question...

The was this slit at the automated door of our resuscitation room, the wife was peeking through the slit during the resuscitation. Well, with the introduction of automated chest compression machine, less man power is needed and scenario is less chaotic compare to the pass. Could understand the feeling of family, seeing less and less staff remained in the resuscitation room, from 4-5 initially to only 2 prior to the “CALL”.

Well, yet there is nothing could be done as it is the will of GOD and I could do nothing… It is a very impolite act to ask such question – questioning our team effort especially when we had really done the job to our limit.

I went to the nursing department personally later in the afternoon and requested for a folding screen in the resuscitation room, less peeking, less trouble…