Triage: Prioritising Lives

(0% fiction,100%realty)

“Life was created…or perhaps it sprouted up from nowhere all of a sudden. I was born. I needed air to live. I breathe in and out at least 16 times in a minute. I never care if what I expire can choke my neighbour. I have power. I can create life but not at the same pace at which I take it. “

The stethoscope that adorns my neck was once an ornament that made me ‘look’ a doctor. It set me apart from a nursing student who too wore a white coat. With the passage of time, it let me hear the non-stop machine that panted ‘lubb dupp’ and now I was using it to detect life.

“The heart still beats”, shouted Neha. We were rushing to the SICU (Surgical I.C.U). I was holding the Ambu bag. I felt thrilled. I was pumping life into him…oxygen.

I knew he was breathing. I didn’t care if it were the last puffs that he got to gasp. A multitude of thoughts flashed through my mind. I didn’t exactly know why the M.O (Medical Officer) chose us to accompany the patient; did he overestimate the fourth year students who were posted at the emergency room?
(The patient was brought 15 minutes back, drenched in blood; an old man in his sixties; a case of road traffic accident. He had sustained severe head injury)

I could see his abdomen rise and fall…rise and fall…yes he was alive. I kept on pumping, a puff every 5 seconds.

I wished the elevator would ascent faster.

Neha once again checked if the tiny organ was still panting. Yes, it was.

Lubb dupp…lubb dupp

The attendant who pulled the trolley seemed to carry a ‘mask like face’…the kind of face that one gives when suffering Parkinsonism. He was sweating just like us.

The poor old man who lay in the trolley knew nothing; he was helpless and not even his pupils could move in response to light, the energy that keeps life alive.

People who flooded the corridor gave way for the sprinting trolley.

Someone else was panting too…running at the same pace as we were. It could been his son or brother or a relative. I was damn sure the guy was not a stranger filled with compassion.

Finally we reached the SICU (Surgical Intensive Care Unit). Our job was over, the patient was ‘delivered’. Now all that I cared was to get the Ambu-bag back (the surgery casualty was short of supply and SICU had its own Ambu-bags).

“Hey do a CPCR!” yelled a house surgeon.

Why me? I have never done this before. I checked if Neha was puzzled just like me…no…she was about to jump over the patient to break his ribs and give the lifesaving resuscitation.

Well in that case why should I miss my chance?

“Sir…errr…I need a demonstration…or in plain terms…I am short of confidence”, I spoke, and waited for the house surgeon to shout.

But he was cool and calm and taught me how to do it.

‘1-2-3-4-NOW…’I said and Neha pumped the bag.

After a couple of tries, I turned to Neha, “Want to try?”

It was Neha’s ‘chance’ now and I took the Ambu-bag from her.

‘Okay, that will do’. The house surgeon checked for a carotid pulse. With his fingers still on the patient’s neck, he turned to the fellow resident and asked if the patient ‘really’ required to be put into a ventilator.

I didn’t understand why these guys were damn so cool. What the hell where they waiting for? This was why ‘we’ soaked our coats…drenched ourselves in sweat?

It took me a couple of seconds to get a grip on what was going on. The poor old man was almost dead…perhaps the brain was already off when we rushed him out of the emergency room.
The Medical Officer had done all that he could do within the four walls of the room. So he sent us with this patient. He was correct. By this time at least five new emergency cases would’ve got attended by the senior residents, who were back at the casualty, seeing to patients who had better chance to ‘survive’.

The stethoscope was not fabricating sounds. The beats were kept alive by the injected Adrenaline. They receded once the action of the drug exhausted. The abdomen did not move once I stopped pumping oxygen. A ventilator…the ultimate and the last hope to rejuvenate life…must be reserved for a ‘better’ case…someone who had a 0.1% better chance to survive and not a ‘dead’ patient.

We had ‘lost’ him on the way to the SICU.

Neha and I walked out of the SICU. The guy who was running with us was waiting there…I didn’t know what to say.

‘Sir, please…I can stand anything…please say…is there a hope?’

“Well…we are trying all that we can do…” before I could complete, Neha interrupted, “The chances are too low”.

I felt a bit frustrated…felt offended.

Who cares…? It was 8.00pm and our shift was over.

I returned home…having learnt something new.

‘TRIAGE’… Prioritising ‘Lives’.

Someone was dead and tomorrow his body will go through the post-mortem examination…torn open, and then sutured back…samples will be sent to various laboratories…final reports will be written.
Someone will shed tears; some others might smile; weeks or perhaps months may pass and all will be back normal.

(Triage means the assessment of the seriousness of wounds or illnesses to decide the order in which a large number of patients should be treated. CPCR stands for Cardio Pulmonary Resuscitation. A ventilator is an equipment that maintain a flow of air into and out of the lungs of a patient who is unable to breathe normally)

(Thanks 2 diva nawale, de title sprouted up during a chat session, and Amooma...i broke her sleep just 2 read out de entire post !!! and Azgar)

(entrant for ‘Get your story published in The Chicken Soup for the Indian Soul – Indian Doctors at BlogAdda‘)