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Emergency Room Diaries #6: Asthma Code! (By Gloria M. Trainor, R.N.) by Karen Lynn Vidra, The Texas Tornado
Monday, November 1, 2004
Rated "PG" by the Author.
A team of nurses and doctors battle to save a small child with asthma.
No matter how hard you try or how regularly you see it, you can never get used to children being involved in some major illness or accident. You aren't prepared to deal with death or the threat of it, especially if the patient happens to be a child or even an infant.
We had a child come in to our emergency room today, a little boy of about five, suffering from what appeared to be a serious asthmatic attack. His little face was blue-grey, his lips were purple (as were his fingernail beds)--this told us immediately that he wasn't getting enough in the way of oxygen, and something needed to be done in order to save him--, his little heart was racing wildly inside his small chest, and his eyes held a look of abject terror as he fought and gasped for nearly every breath.
Asthma was a familiar foe we faced in our E.R.: if it wasn't a child, some teenager, adult, or elderly person was stricken with it, and sometimes the attacks were mild, while, on other occasions, the attacks were severe or even life-threatening. How often we had to try to revive a small child who had stopped breathing, or an adult who was so blocked they were hardly getting any air in at all into their lungs, or an elderly person who was gasping like a fish out of water as they attempted to breathe. We saw it regularly, and often, and it seemed that in the past few years, the number of asthma cases only increased (and was continuing to do so at an alarming rate).
We knew what to do in the event of an asthmatic emergency: try to get the person's airway open as soon as possible via medications, give them extra supplimental oxygen if they were having a great amount of difficulty in breathing, check the levels of oxygen in their bloodstream via an arterial blood gas (usually performed in the wrist, but if for some reason, we couldn't do it there, we'd get a sample of arterial blood from the person's neck or groin area), and hopefully arrest the attack in its track and save the stricken person's life. We would also give "breathing treatments" to further open up blocked airways, and we would closely monitor the asthmatic person while they were under our care.
Anyway, back to my story: this little boy we saw today was in bad shape upon coming into our E.R.: he was having a great amount of difficulty in breathing, his ribs were standing out with every gasping breath, his color was poor, and his blood gas readings were terrible. We knkew he was in trouble; but when his little head fell back and he then went limp, I tell you, my heart dropped clear to my toes. We knew we had to do something fast if we were to save this boy's life; and we immediately sprang into action.
I attempted to insert a pediatric-sized airway down the little one's throat (but was met with resistance at first; therefore, I suctioned the little guy's throat, amazed at the amount of mucus and vomit that was in his airway; no wonder he had so much trouble with his breathing, I surmised) while my colleagues started hooking the little boy up to monitoring equipment, I.V. lines, and other tubes, and I then quickly attached a child-sized Ambu (or breathing) bag to the airway tube and just started squeezing every few seconds, in the hopes of getting precious, life-giving oxygen to the little boy's lungs. While all this was going on, Louisiana, the charge nurse (who happened to walk in; so I had her help) performed several blood gases on the boy. The ABG's are normally painful for anyone who has to experience them; but this boy was out. He didn't respond to the painful pinch of the needle as it went into his wrist, and his pain reflexes were almost nil. Not good. This kid was clearly on his way to checking out. This made the situation more desperate, and we only worked harder in trying to save the little boy, hoping and praying for some type of Miracle from Above.
Unfortunately, we never got that Miracle. The little fellow died despite our efforts to save him. He was but a little boy of four-and-a-half, five years at the most. Just when he should have started enjoying and discovering life, his life was over; and because of an insidious chronic disease known as asthma. When he had his attack, things should have been done right away, but his scared parents panicked, and they waited too late for help; and now, as a result, the little boy was in bad shape upon arrival to the E.R., and no matter what we did or tried, we just couldn't save him.
I wish this little guy had lived, like a lot of my asthmatic patients have done; but as a nurse, you lose some, and you win some, and you can't expect to save every life you come in contact with. Still, death is a part of life, and as a nurse, one has to learn to deal with it on a daily basis and go on when it does happen. But it sure does hit you hard, particularly when the victim in question is no more than a mere infant or child. It just doesn't make sense when a baby or child dies, and it never will; it goes against everything you have learned, and this is one thing that makes it so hard to deal with (and accept).
asthma can be a killer, as you describe in this dramatic, well written story. thank you for educating the public.
(((HUGS))) and love, karla. :)
Reviewed by Judy Lloyd
11/1/2004
There was a doctor in our community that died from an asthma attack. Nothing could be done. Whether it is man dedicated to his profession or a little boy. The loss is painful. I have asthma but have not had as severe attack as this. God bless you for a excellant write.
Rovella is a beautiful woman with a cold heart whom blames herself for an unfortunate old family secret that is literally ruining her life. This secret impedes a gorgeous woman from having happiness in her childhood, and throughout her life. Dark sec
No matter how hard you try or how regularly you see it, you can never get used to children being involved in some major illness or accident. You aren't prepared to deal with death or the threat of it, especially if the patient happens to be a child or even an infant.
