THE THIRD DAY

Today is Wednesday, June 26, 2024. It is my third day at Revathi Medical Center in Tamilnadu, India.

Yesterday, I had to say goodbye to the emergency room. However, today I started at the Intensive Care Unit, more commonly referred to as the ICU. Technically, I was supposed to spend today in General Medicine with Dr. Santosh, but he was swamped with patients. So, I was sent to the ICU instead.

The head nurse, Kirthi Akka, showed me the nurse and doctor's notes. They have numerous charts that they use to log the patient’s risk level and everything they give the patient (medication), anything they change (once again, medication-wise), and the patient’s vitals.

Then, Kirthi Akka showed me the carts of medicine and the machines used for patients. She introduced me to someone else who taught me the mechanics of the ventilator. The ventilator screen shows a number in the top right, this reflects the patient’s heart rate. The number below the heart rate shows the oxygen saturation. Also, the ventilator can only be used on unconscious patients. While learning about the ventilator, I was introduced to medical air, which is pure, man-made air that is only used for medical purposes. Ventilators only require oxygen and medical air. There are two types of ventilators: both require medical air, but only one requires oxygen.

Kirthi Akka also introduced me to the “crash cart”. The crash cart contains emergency medicine for certain emergencies, specifically code blue (cardiac arrest). Above the crash cart, they have a brown box, double-locked, containing narcotic medicines. It is locked because these medicines can be addictive and need to be stored securely, out of reach from patients. In case a patient’s body temperature drops, there is a patient warmer which provides hot air for the patient.

While observing patients in the ICU, I learned that CNV refers to non-verbal patients. In the ICU, most patients are also bedridden. While bedridden, patients are highly prone to forming back ulcers. Also, bedridden patients without leg movement can form blood clots in their legs. So, the ICU provides thrombolytic phacolytic to prevent the ulcer and blood clots from forming in the first place.

Furthermore, I learned that the hospital disposes waste differently because it can infect the environment. The blue waste bin is used to dispose of glass, the red is for plastic, the yellow is for items that come into contact with skin (band-aids, etc.), and the green is for general waste.

The ICU has its own stock of medicine and antibiotics, unlike other departments that have to buy medications from the hospital’s pharmacy. The ICU keeps a cart of medicine in the very center of the room for easy access during emergencies.

The ICU also has an isolation room which is only used for cases like HIV, which is highly contagious. The isolation room is also specifically for high-risk patients, like people with pre-existing conditions, or those of especially old or young ages.

My third day at Revathi ended at the ICU where I met the doctor who was in charge of monitoring the ICU patients. She quizzed me on everything I learned, and I passed. My first day in the ICU went by in a flash!