Pass

The first one I wasn't as worried about. Sure, a little worried. I would have paged the doc if I hadn't known he would be here in an hour to see her.

He came by. He offered nothing. Left before I could talk to him. But what would I have said?

"Hey man. Doesn't she seem a little rough? Can't we do something?"
"Absolutely Jake. I got you. This patient was about to go down the tubes, but your accurate, yet totally nebulous concern saved her!"

An hour later the call light went off. I had just been in there fifteen minutes ago talking with her. Stuck my head around the door five minutes later, but the NA was there. I mean I know when the fucking train is coming. I have my ear to the ground.

Call light. Open the door. She is gray. I mean just gray, man. Shit.

I yell at her. Grind my knuckles into her chest. Her eyes flutter, maybe she groans. Quick assessment yields steady heartrate, BP holding, oxygen...oxygen is for fucking shit.

"Give me a bag!" "Call a rapid!" I can bag her up I think. I've bagged people up before. You just shove that mask on her face and squeeze 100% oxygen into her lungs.

The first rapid nurse comes in the room says/thinks "Oh, shit" and hits the code button. 5 docs and 7 nurses show up a heartbeat later.

We wait, respiratory therapy bags her up to a passable oxygen level. Blood Pressure keeps holding, Heart Rate steady. But she won't breathe on her own. We ship her off to the ICU to be intubated. I could have bagged her up by myself, but it wouldn't have done any good.

One Month Later:


Today, I'm definitely more worried. I take one look at the patient and wonder where the fuck last night's nurse wandered off to. Are you kidding me? Is this how she is? Cause this sucks.

Outside the door sits the doctor. We talk. Sure she is a little worse than yesterday, but that nursing home transfer is just a little away.

Hooookay then, I will page the respiratory therapist, hope that sorts her out. And why do I worry so much, am I a baby or what?

An hour later. Call light. I have a bad feeling. Why? I don't know. Or are the two events so close in my mind that I assume I had the premonition? Call lights go off all the time. Why did I think this woman was in critical condition?

I wasn't surprised, so I could act instantly. This time wax. An empty yellow. I see her take a breath:

Agonal respiration is an abnormal pattern of breathing characterized by shallow, slow (3-4 per minute), irregular inspirations followed by irregular pauses. They may also be characterized as gasping, labored breathing, accompanied by strange vocalizations and myoclonus. The cause is due to cerebral ischemia, due to extreme hypoxia or even anoxia. Agonal breathing is an extremely serious medical sign requiring immediate medical attention, as the condition generally progresses to complete apnea and heralds death.

I only need to see one. I think it takes me three seconds to assess and hit the code button. People start running.

"Its real!"

Before I know it the room is full. So full I can't get to the computer, can't really even touch the patient. The code team is at work. My friends are there, skilled critical care nurses. They run the code like heroes.

"How are you doing, Jake?"
"Oh, geez, you know."

And I think they do.

They work for 20 minutes. But then that is it. She passed.