My oncall last night was calm, alhamdulillah.... until 5am. I received an update from my colleague that he was going to ED for a new referral - intraabdominal injury, a condition in which I feel challenging to attend other than brain injury.
MVA - motor vehicle accident.
I am not sure about the exact history, but this patient, Uncle L was riding a motorcycle and accidentally hit the tree. We are not sure about the mechanism much but it must be a very serious accident as the patient came to ED unconsciously. Blood pressure started to drop, which may indicate some bleeding was going on.
He successfully underwent emergency operation (exploratory laparotomy + splenectomy) which mean, we cut open the abdomen to find out what was going on inside. There was at least a kidney dish filled with blood clot and approximately more than 3L of blood loss. And the spleen was totally injured and need to be removed. Few segments of liver were contused as well.
Anyway, do you guys know how much blood the heart pumps out every minute? 5L/min!
And he lost more than half of blood in the body. So many blood transfusions going on this morning, my friend became runner to fetch blood between blood bank and operation theater. At least 3 large bore branula were in situ - one for packed cells, one for cryoprecipitate & fresh frozen plasma, one for IV drip.
He was still in critical phase and admitted to ICU post operation.
And actually there was another patient at the red zone this morning, he was also unconscious, lying flat just beside the patient we were preparing to transfer to operation theater just now.
Informed by my friend, he already passed away this morning, in his baju melayu and kain pelekat after finishing his Subuh prayer and he was being hit and run. Arrived in ED with no pulse, cardiac monitor showed asytole (no heart rhythm), I've been told CPR was commenced and the team was unable to revive the patient.
May Allah bless you pakcik T_T
MVA of Uncle L and pakcik was not related, anyway.
Becoming numb and numb T_T
SS, Perak, Malaysia
190512
