Memoirs of an Emergency Nurse Read Online Free PDF Page A

the waiting room, talking to a patient sat down about to be discharged.
    I turned around to behold the walking dead.
    The man stood before me a ghastly shade of pale white and grey, his skin had a waxy glow from sweating profusely; he struggled to get his words out and was breathing heavily.  He had a very confused look on his face, clearly from the lack of oxygen. As there were no seats available, I moved him over to hold on to the wall, grabbed the nearest wheelchair and moved him into the resuscitation room. This man was clearly unwell and about to collapse at any minute.  He had the classic signs of a heart attack.
    He was in serious need of treatment and I dared not leave him for a minute. He was very slow to do anything, due to the lack of oxygen getting to his heart and brain and I could only encourage him to sit on the wheelchair so I could move him into resuscitation and start assessing him. Once in the resuscitation room, the patient’s confused priority was clearly different to mine.
    Firstly, he didn't want to get on the trolley with his shoes on. He stopped, looked down and was about to take his shoes off until I firmly stopped him. He then turned 360 degrees to get his bum on the trolley rather than just doing a right turn, all taking seconds off his treatment time. Once he was on the trolley, I told him to take his jumper off and he obviously didn’t comprehend my urgent tone of voice. He slowly took his jumper off and started to fold it ever so carefully while I was preparing the observation machine. He then started to undo the first few buttons on his shirt slowly.  At this point, I could wait no longer. This man looked as if he would die any second and his inability to act quickly gave me even more cause for concern. With swift efficiency and a sense of urgency, I slid the top layers of clothes over his back and head to reveal his chest, without pausing to fold them              
    I was talking to him to gain information as I assisted him to get undressed. I attached ECG leads and a blood pressure cuff, set the machine to start recording and placed an oxygen mask over his face at full maximum flow rate. I was gaining vital information about the presenting complaint and how long he had felt unwell for, allergies and medical history. I recorded an electrocardiograph, which interpreted the electric current in the heart, and I could interpret that this patient was having an acute myocardial infarction. I called over the intercom for a doctor to come to the resuscitation room and swiftly gained intravenous venous access and blood samples while waiting for whichever doctor was free to attend. The man remained a pale shade of grey; he found it hard to talk and was very sleepy.
    At the very moment the doctor walked through the resuscitation doors, no more than five minutes after I got him there, the patient stopped talking mid- sentence, let out a deep breath, laid his head back in the trolley and closed his eyes. I couldn’t believe it. Although I had known it was going to happen, I still couldn’t believe it happened in front of my eyes.
    I pulled the emergency buzzer to get other staff members to assist with this now unconscious patient and I knew staff would run in to help me. I collapsed the trolley so the patient was laid flat, gave one hard sternal thump with my fist on the patient’s chest but with no effect, then literally ripped open the defibrillation pads and smoothly stuck them in position on his chest and looked at the cardiac machine for a reading. The doctor was on the other side of the patient and, after looking at the ECG monitor, saw he was in ventricular tachycardia, without a pulse. He charged the defibrillation paddles and was saying “Clear” as other staff members came in.
    The defibrillation joules were administered, causing the patient to arch his back and lift his head from the trolley with full force. Within seconds, he was conscious again. He sat bolt upright, his