May 24, 2012 Thursday
Vitals: taken at 8:00 am
O2 SAT – 95
Heart Rate: 124
Blood Pressure: 160/90
Respiratory Rate: 24
“Finally, we find another way of understanding what she is saying: non-verbals.”
Melit cannot communicate her feelings verbally, so we need to increase our capacity to read facial expressions and body movements.
Comatose patients do express themselves through non-verbal means. Today, Melit looked so weak and pale. And her vitals are in dangerous levels. We figured it is either she is dehydrated or there was so much blood loss. And her heart rate was so high, at an alarming rate of 120-125 throughout the morning. As if her heart is trying so hard to circulate whatever blood is left in her body.
The loss of blood must be cause of she has stress ulcers and she underwent a procedure called Tracheostomy – a process where her throat is opened and a tube is attached to her windpipe. That trache, as they call us, is much easier to clean and easier to suction fluids from. It was a welcome change from the tedious process of suctioning the ET. Dr. Yacapin herself performed the procedure, with Dr. Eduave, her resident and Dr. Miranda as the anesthesiologist.
We discussed these observations to Dr. Casino during her rounds.
Our Doctors said
Doctor Casino agreed with us and ordered a blood transfusion. Unlike private hospitals where the patients have to secure their own blood (whether packed RBC or Fresh Whole Blood or FWB), here at the NMCC, blood can be secured a phone call away by the nurses.
So, while transfusion was going on, she was NPO and the IV line was stopped. But her skin went back to normal and her heart rate went down to comfortable levels of 95-99.
Melit’s former colleague Glo Bonachita came for a visit and gave P500. Small blessings that will go a long long way for her recovery, especially that the combination of ranitidine, vancomysin, mannitol, meropinem, salbutamol, and tramadol cost roughly ten thousand per day.