On Mrs. Le Tuyet Hang, “patient 20” Cai ECMO, probably coming out of the disease, doctor congratulated. But four days later, she fell into a more critical condition.
On 7/3, Department of Emergency, Central Hospital for Tropical Diseases East England received “Patients 20”, 64 years old, in Truc Bach, Ha Noi, a history of vestibular disorders. She was quickly arranged in the quarantine zone and started treating Covid-19.
The first seven days of treatment, she stabilized health, self-travel, laundry and normal dining. On the eighth day, her illness suddenly disappeared badly.
Dr. Nguyen Trung Grade, head of emergency department, still remember that in patients with shortness of breath increases gradually in the afternoon, up to 22h of respiratory failure. The condition of respiratory insufficiency is very fast, until the night has serious bad, must immediately put endotracheous duct, for mechanical ventilation and dialysis, then move to the Department of active resuscitation.
Doctors did not know much about the Covid-19 disease.
“We later knew that Covid-19 could be heavy and fast in just a few hours, around the 8th day of the 10th day of the illness. The CA then, we do the more calm, “level doctor said.
On 15/3, patients with pneumothorax, severe progressive respiratory failure can not sustain life with optimal mechanical breathing measures. The treatment team reports the situation to the Department of Health’s expertise and receives an ECMO intervention (over-the-body oxygenation).
Ephesians the most astute doctor was mobilized to perform ECMO. “In just about 30 minutes we have finished setting up the ECMO system for patients”, Doctor Dong Phu Khiem, deputy dean of positive resuscitation, recalled. When the patient’s condition is temporarily more stable, both the new Kip breathes a sigh of relief, the shaking limbs step outside.
The next few days, four more heavy patients were transferred to the faculty. Y doctors split up and sit the couch with no smoothness to monitor the indicators on the screen, in the treatment room limited people out, only the machine noise operation.
“There must always be a follower of patients in the room, timely detection of unexpected situations”, Doctor Tran Van Kien, Faculty of positive resuscitation, said.
Each live shift lasts 12 hours, tentacles have four nursing and a doctor. They instead eat, sleep, go to the toilet, familiarize them with the secret of wearing a tight protective layer. There are people wearing the N95 for so long that they suffer from facial ulcers, bleeding in the nose and cheeks. Doctors desk, devised the measure of buying foam padding to the edge of the page to continue to work long term.
After 17 days of intervention, her condition was much more than once, given the ECMO withdrawal. “Now, you’re so excited. Everyone saw the light in the end of the tunnel, as the ECMO withdrawal was about 60-70% of the road, “said Dr. Khiem.
But that joy doesn’t last long. Night 7/4, she suddenly stopped heart. The doctor in the room detects the indicators of abnormal patients, has notified the colleague.
That night, Dr. Khiem was not directly for a break after 12 hours of continuous work. But the patient’s condition is very bad, he spends some time resting so as not to stop concurating more material to study, find effective treatment.
0h40 am 8/4, from head of department to a doctor who is fighting outside the recovery room, the whole steam to the resuscitation room for emergency. Hospital Please consult the Board of Health.
30 minutes of rescue resuscitation, the patient’s condition does not improve. Afraid to lose the patient’s life into death, Dr. Khiem and group resting after the shift is also mobilized.
For more than 40 minutes, the Doctor group and Electric shock nursing for her three times, under the direct direction of the Dean Doctor and the suggestion of the Board of Health professional. Eight people, consisting of four doctors and four nursing to replace heart presses by hand, both make sure to maintain a pressure of about 100-120 beats a minute, both to learn and to treat the cause of cardiac arrest. They’re up. If wrong technique presses, the patient does not have periodic or emergency no sense.
“Forever that the patient has no response, we were desperate. Earlier many times the emergency patient was heavy, the success rate was not high, “Dr. Kien said. They call the home to exchange.
Luckily, emergency measures are effective. She has a heart rate back, and the emergency group is also buttery. But nobody dares to sleep for fear. Patient will continue the occurrence of the incident.
40 minutes of emergency haunts the Doctor humbled now: “Such an emergency is terrible. Having passed through the administrative room saw the brothers review the video footage at the time to withdraw the experience, still feel shaky thought to have pressed heart for her again “.
That stop of the heart also makes treatment nearly a month like pouring the river into a tank. Patients with multiple organ damage, aggravated heart failure, increased infection, lung damage was far more deteriorating. The Board of expertise considers the ECMO back.
“It’s time to do it again,” says Dr. Khiem.
More than a month net continued treatment, up to 15/5 days, the patient has stabilized and withdrawn the breathing tube, can travel exercises. “With such a doctor is nothing more wonderful”, Dr. Khiem said.
The Doctor group is not exhaustively worried for her and will continue to improve the problems in the care so that the patient is recovering, being discharge.