Have You Had a Miracle Patient?

         I found this story at Medscape and thought it would change the perspective of health professionals, especially nurses, on dealing with critical care situations. It  gave me some insights and I also learned something new from it (the hypothermic protocol mentioned, which is not a pratice yet here in the Philippines).

Have You Had a Miracle Patient?

Posted By: beka serdans, Critical Care/Intensive Care, 10:43PM Mar 5

” Little is Better than Nothing”

Well, this weekend seemed to be Code City in our ICU. Some died, some lived, and some were in a vegetative state surrounded by their families. I had the opportunity to admit a 64-year-old lady who had been found slumped over the steering wheel of her car in a unconscious state. When EMS arrived they found her in VT —-> Vfib —-> pulseless state. They quickly began their ACLS EMS process, intubating her right away, shocking her along the way.

She arrived in the ER where they performed a bit more CPR, got her vitals back, placed her on high dose inotropic support, and brought her up to the ICU with a systolic blood pressure near 68/?, along with a strange rhythm by EKG - undecipherable by our Fellow. Our hypothermic protocol was initiated as her pupils were fixed and dilated right away. She had been down and out for at least 20 minutes. We packed her in ice and dropped her temp below 98.6 F. None of us were quite sure if she would survive, but hoped that brain function would be preserved by the hypothermia.

Four days later she was sitting up, extubated, and smiling at her family, yapping away about the food left in the back of the car. She had survived, but could not recall all the events except slumping over her steering wheel. Now, this was a definite MIRACLE patient. A nice save. Sometimes it’s best not to give up on patients clinically when all things look dire. Seems that often we do that more than we should…