THE SECOND DAY

Today is Tuesday, June 25, 2024. It is my second day at Revathi Medical Center in Tamilnadu, India.

Today I will be in the Emergency Room (ER) for the entire day. As I start my shift, there are two patients in the ER, two elderly males. The first patient seems to be indigested and has vomited once. The patient is restless and constantly attempting to remove his oxygen mask. The patient is 84 years old. The doctors suspect that the patient has developed some throat problems. The patient continues to vomit; he has vomited a total of five times. The patient was prescribed medicine and advised to rest. The nurse suggested that the patient’s family monitor what the patient consumes. The patient vomits once more.

The nurse decides to move his bed so that he can rest and free up space in the room for more patients. The patient gets a chest CT ordered since he has thrown up twice again. His throat is hoarse and his words are difficult to make out.

While this patient has been left to rest, the ambulance arrives. The doctor heads outside to check on the patient, but the patient’s eyes show no sign of life and there is no pulse. The patient had fallen at around 9:45 in the morning. The time of their arrival is 10:40. The patient’s entire body seems to be swollen up and the skin seems washed out, showing a yellow-like color. The patient was hooked up to the heart monitor, but no pulse was able to be found. The patient was officially declared dead. The patient was 75 years old.

The patient is considered a raw death, meaning they passed away before arriving at the hospital. The nurses are currently taking the patient out to the family so that they can see her. They covered the patient in a cloth and are now taking her home.

Meanwhile, I learned that the patient from yesterday who had fallen went into neurosurgery. I also learned that the tube they used to help him breathe was called the Endotracheal Tube (ET). The endotracheal tube was inserted into the trachea (the windpipe) to provide oxygen and protect the lungs while they operated on his neck. The endotracheal tube goes into the lungs and pumps air so that the unconscious patient can breathe. I learned that the patient’s fracture was on the occipital bone, which is a large, flat bone that makes up the base of the skull and the back of the cranium.

After this, I went to the Injection OP’s office. The injection OP specializes in giving injections. If the ER needs to do an injection, they can do it themselves; however, if a doctor needs a patient to get an injection, they must go to the OP. If blood is extracted during the injection, then the needle is in the right spot. However, if no blood is extracted, then the injection was done incorrectly. The first injection that I saw was for a patient’s stomach problems.

After I spent time with the injection OP, I returned to the ER. A patient came in with a fractured knuckle and a cut tendon. The tendon is the muscle that allows the upward and downward movement of the finger. The patient’s upper tendon was cut, leaving it hanging without support. Currently, the patient is holding it up with a brace to not worsen the knuckle fracture. To fix this cut, the skin needs to be opened, and the tendon needs to be stitched. To properly repair the muscle, it needs to be held up by a finger brace for three weeks.

Meanwhile, the vomiting patient continues to throw up periodically, usually when he coughs. The nurses suspect that there is a mucus buildup that comes up whenever the patient coughs.

Later, another raw death patient comes into the ER. The patient had died on the way to the hospital. To determine if there’s life in a patient’s eyes, shining a light in their eye will cause the retina to dilate if there is still life. However, if the patient has passed on, the retina will not change. Then, if there is no dilation, the doctors will check the pulse. If there is no pulse, they will declare the patient dead.

Then, the Injection OP took me back to her office. I found out that she also is in charge of removing stitches. She taught me how to remove them, as well. First, one must lightly pull the stitches with tweezers and then cut them with scissors. Then, you must pull the stitches out of the patient carefully. In the case that she showed me, the patient had stitches in his arm. The patient had 12 stitches on his tricep. He had it bandaged, per his request, and was told to wash it lightly.

Then, the vomiting patient was visited by the ENT (ears, nose, and throat specialist) to check up on his status. The patient was left to rest. However, while the other nurses were attending to different patients, the vomiting patient required assistance. The nurses told me to help him, so I went and asked him what he needed. He was difficult to understand since his throat was hoarse. However, I understood that he asked when he could leave. I told him that he could leave soon. He then proceeded to tell me that he needed to throw up, so I held the bowl up for him while he threw up once again.

Then, I was sent to the third floor wards to deliver an oxygen mask to one of the college interns. After I delivered the oxygen mask, my shift was over. My second day was extremely eventful, after all.