Syncope

Today is a very teleserye like day in the emergency room.

After I admitted a pregnant woman in the delivery room, there came a female patient aged 73 years old, who immediately fainted after reproving two youngters who were having a fight. This sudden fainting is what we call syncope in medical term.

So what happened awhile ago, this lola was carried by her grand daughters and some guys in the emergency room.

As for the hospital’s protocol, only the patients who had undergone antigen swab test which tested negative are the only ones who can enter the emergency room. Initially, they must be handled first and seen in the triage if the patients and the relatives have no RTPCR or antigen test.

So, our security guard awhile ago, got panicky when the grand daughters were crying outside the ER, crying out to help their lola.

The security guard informed me immediately. However, he left his post to go to the triage to get a wheel chair. So, the relatives entered the emergency room without swab tests.

I was in a state of shock, not because of the person who fainted, but because of the persons who entered the ER.

Then, this grand daughter was calling my attention to help their lola. “Nurse ka, bakit wala kang ginagawa??!”

I told them, “Maam, sandali.”

I told them that they are not allowed to enter the ER but they infiltrated the door, because the guard left his post.

The Nurse Assistant Maam Michiku took the lola’s vital signs, and did her initial assessment. Then, I informed the resident on duty that the patient still had no swab and was taken inside the ER. So, the entire emergency room now was exposed. I was reprimanded by our resident. And in turn, I reprimanded as well the security guard not to leave his post. Since, it will take four hours to disinfect the ER via UV light, and there are also other patients that we need to cater.

I took the Capillary Blood Glucose of the patient. I took also the ECG. So, the result had inverted “t waves”

The orders of the resident were as follows:

Take antigen test, then…

  1. CBG,
  2. ECG,
  3. X Ray,
  4. Na (135 to 145 meq/L)
  5. K (3.5 to 5 meq/L)
  6. Creatinine (60 to 110 umol/L [Female] & 70 to 120 umol/l [Male])
  7. Troponin ( 0.00 to 0.04 ng/ml)

The result of the antigen test was negative,

CBG was 107 mg/dl,

ECG had inverted “t waves”,

X ray had slight prominent densities,

Na and Potassium were sent out from the hospital because the laboratory had no machine for it. The result after two hours of waiting was with in normal range.

Then, Creatinine was also within normal range, and troponin qualitatively was negative.

I’ve learned today that Troponin can be taken qualitatively and quantitatively. However, the hospital only has qualitative result only for Troponin.

Troponin is an enzyme or protein that is used for the evaluation of heart injury.

Moving on, the patient woke up and she had a GCS of 15, responsive, coherent and conscious. Thank God.


So, the funny part of this day was the security guard made his amends to me by giving me four green carabao mangoes before the duty ended. Para daw bati na kami. Hahaha!

I gave one mango to Sir Chrysan who was having his last day of duty for tonight, then another mango to Maam Anjo, the midwife at the triage. So I was left with two green mangoes.

I thank the guard and I told him not to leave his post anymore. I told him that it’s okay to go to the triage but it should not be wrong timing. Hehe.

So, I had a wonderful duty today. My resident doctor gave me a dinner meal of milkfish and rice. Also, another blessing awhile ago was our lunch from McDonald’s donated by a kind soul who did not tell his identity.

Thank you Lord for the sustainance. 🙂