so about 5:15 things were quiet in the PACU & someone asked me to take my roommate Anne her camera back in surgery. I gave it to my new BFF Heather who then said to me "We have some cute babies on all the tables why don't you take some pictures. (Tender mercy #1 was Heathers suggestion - Tender mercy #2 was me saying yes)
I went in & out of all 5 surgery rooms - I had just stepped out of room #4 when I saw Judith our Intensivist & Doug the Team Leader running into room #3. So like any good PICU nurse I followed...the baby was flat lined & I asked the obvious "Do You Want More Help?" to which they said yes so I called for the OR crash box then RAN at full speed sliding in my shoe covers on the slippery floor & went into the PACU to get the Pre Drawn emergency drugs we had ready then raced back telling Mary Laura to come with me as the PACU nurses are often the code response team. When I got back CPR was in progress Mary Laura arrived later so I drew up drugs & she gave drugs...we gave a dose if Epi with no improvement so we doubled it & got a heart rate of 79 back with a 3rd dose it went up to 170. The vigorous hand ventilating gave her a distended tummy so we decompressed that, we gave bicarb & lasix then prepared for rapid sequence reintubation. Heather was in as the recorder & right hand helper as well as a room full of onlookers. When things were a bit stable we carried her to the PICU for some resp treatments and 100% oxygen. Poor Joe out PC was white as a sheet - he said in all his missions this had never happened.
I held her & rocked her in the PACU for an hour with continuous treatments & Oxygen. Mom came in & we explained it all - this happened at the conclusion f her surgery so her repair was done...We could not get her off the Oxygen & she couldn't go to Post Op needing so much nursing care. There was not an ICU at this hospital so the option was to transfer her to another hospital with an adult ICU Mary Laura & I said at the same time - "NO don't send her out - we will stay & take care of her"
All the team leaders had to have a meeting to review all the options & in the end Mary Laura & I set up our own little PICU in the "crash bed" on the floor with all that we needed and were able to stay over night. They were all a little worried to leave us but we were fine...before the team leaders all left for the night EVERYONE of all faiths...Jewish, LDS, Catholic, Non Denominational Christian etc all agreed that God had His hand in providing help to this sweet little Sandy....from Heather telling me to take pics, to the route I took so I was near the room, to having Judith & Doug back there outside that OR....so many "What Ifs?" but ALL of us were put together on this mission for many reasons however this may have been the most important.
Joe ordered us Pizza & Diet Coke to get us thru the night & Mary Laura & I took 2-3 hour shifts. We really could not get her weaned from the oxygen but we at least gave her the chance to "declare herself" under our care. In the morning they were able to coordinate with a pediatric friendly ICU & she was transferred there to be watched (post story since I am writing this so long after the fact she did great & they got her home 2 days later)
Friday was a half day of surgery & packing up - ML was wired on Coffee & insisted on staying then took a nap there - I went home with the night nurses...and that was a crazy ride...our driver barely nudged another car & that driver got out & basically threatened our driver unless he paid him $$$. It was crazy. I got to the hotel showered, slept for a few hours then called the hospital to go back & pack up & they were already done!!!
When Heather got back we got a cab & went to the Guatemala City temple which was not too far away - it was fun to see & right next to it was one of the South America MTCs so we saw LOTS of missionaries coming & going. We met a sweet couple & their son who was staying at the temple childcare area while they attended a temple session. Also another sweet lady who hugged us & called us her sister. It is times like these when you see just how small the world & our worldwide church is...
Friday night was the team party at our hotel which was nice so we didn't have to go anywhere. It was a fun party & a GREAT TEAM. I am SO VERY BLESSED to have opportunities & experiences like this. Truly this is what nursing & the Healers art is all about - helping those who so need what we all can offer.
I went in & out of all 5 surgery rooms - I had just stepped out of room #4 when I saw Judith our Intensivist & Doug the Team Leader running into room #3. So like any good PICU nurse I followed...the baby was flat lined & I asked the obvious "Do You Want More Help?" to which they said yes so I called for the OR crash box then RAN at full speed sliding in my shoe covers on the slippery floor & went into the PACU to get the Pre Drawn emergency drugs we had ready then raced back telling Mary Laura to come with me as the PACU nurses are often the code response team. When I got back CPR was in progress Mary Laura arrived later so I drew up drugs & she gave drugs...we gave a dose if Epi with no improvement so we doubled it & got a heart rate of 79 back with a 3rd dose it went up to 170. The vigorous hand ventilating gave her a distended tummy so we decompressed that, we gave bicarb & lasix then prepared for rapid sequence reintubation. Heather was in as the recorder & right hand helper as well as a room full of onlookers. When things were a bit stable we carried her to the PICU for some resp treatments and 100% oxygen. Poor Joe out PC was white as a sheet - he said in all his missions this had never happened.
I held her & rocked her in the PACU for an hour with continuous treatments & Oxygen. Mom came in & we explained it all - this happened at the conclusion f her surgery so her repair was done...We could not get her off the Oxygen & she couldn't go to Post Op needing so much nursing care. There was not an ICU at this hospital so the option was to transfer her to another hospital with an adult ICU Mary Laura & I said at the same time - "NO don't send her out - we will stay & take care of her"
All the team leaders had to have a meeting to review all the options & in the end Mary Laura & I set up our own little PICU in the "crash bed" on the floor with all that we needed and were able to stay over night. They were all a little worried to leave us but we were fine...before the team leaders all left for the night EVERYONE of all faiths...Jewish, LDS, Catholic, Non Denominational Christian etc all agreed that God had His hand in providing help to this sweet little Sandy....from Heather telling me to take pics, to the route I took so I was near the room, to having Judith & Doug back there outside that OR....so many "What Ifs?" but ALL of us were put together on this mission for many reasons however this may have been the most important.
Joe ordered us Pizza & Diet Coke to get us thru the night & Mary Laura & I took 2-3 hour shifts. We really could not get her weaned from the oxygen but we at least gave her the chance to "declare herself" under our care. In the morning they were able to coordinate with a pediatric friendly ICU & she was transferred there to be watched (post story since I am writing this so long after the fact she did great & they got her home 2 days later)
Friday was a half day of surgery & packing up - ML was wired on Coffee & insisted on staying then took a nap there - I went home with the night nurses...and that was a crazy ride...our driver barely nudged another car & that driver got out & basically threatened our driver unless he paid him $$$. It was crazy. I got to the hotel showered, slept for a few hours then called the hospital to go back & pack up & they were already done!!!
When Heather got back we got a cab & went to the Guatemala City temple which was not too far away - it was fun to see & right next to it was one of the South America MTCs so we saw LOTS of missionaries coming & going. We met a sweet couple & their son who was staying at the temple childcare area while they attended a temple session. Also another sweet lady who hugged us & called us her sister. It is times like these when you see just how small the world & our worldwide church is...
Friday night was the team party at our hotel which was nice so we didn't have to go anywhere. It was a fun party & a GREAT TEAM. I am SO VERY BLESSED to have opportunities & experiences like this. Truly this is what nursing & the Healers art is all about - helping those who so need what we all can offer.
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