Clear and tense the words resound
“No! Her pulse cannot be found”
A panic-stricken moment of silence pierced through the air followed by a flurry of activity between the pair of paramedics who spun into rapid action exchanging terms family members couldn’t grasp.
They injected a bolus of medications directly into the tube attachment and then into the bag.
(“Intravenous” means “into the vein and IV “push” or “bolus” is when a syringe of medication is injected into your catheter to quickly send a dose of drug into your bloodstream to hasten or magnify a response)
One of the medications listed was a drug called Zofran (ondansetron) which works by blocking one of the body’s natural substances (serotonin) that causes vomiting. Zofran is used to inhibit nausea and vomiting caused by cancer drug treatment such as and radiation or chemotherapy.
“Jet fluid” is an infusion of Vitamin B12 combined with a few others into a bag of lactated ringers / saline.
Maaf uncle, you see what happened is – you’ll delayed and unknowingly left her dehydrated too long so it turned into a life-threatening situation. Next time please be careful. Avoid landing into the same situation again.
A weak or absent pulse occurs with cardiac arrest or hypovolemic shock when you lose more than 20 percent (one-fifth) of your body’s blood or fluid supply.
This severe fluid loss makes it impossible for the heart to pump a sufficient amount of blood to your entire body so blood flow is reduced to vital organs and depending on how far her kind of dehydration is left unattended, hypovolemic shock leads to organ failure which can sometimes be irreversible depending on the stage.
Also remember; major electrolyte imbalances can lead to sudden cardiac arrest so you needed to call someone much earlier before it became severe overnight and warranted emergency attention because she showed mild symptoms from yesterday. These red zone signals shouldn’t be taken for granted in the future:
Ice cold, clammy, pale skin
Rapid, shallow breathing
Rapid heart rate
Little to no urine output
Blue lips and fingernails
Loss of consciousness
Unfortunately we don’t have anyone on our team to recommend for your area but please find a paramedic or doctor nearby who can provide early intervention by coming as soon as she displays any symptoms of going into a crisis.
To come from Johannesburg is no problem at all but time constraints are a factor and if we’re on an ambulance shift with other major call outs like today, you can’t afford to be waiting few hours until we arrive because when fluid / plasma volume diminishes further and the veins collapse with shock, blood is diverted to vital areas so peripheral access is denied.
When pressed for time, the next main attempt is a central venous line inserted via a carotid or femoral artery which can come with risks but is life-saving.
Last resort we try our best to avoid is an (IO) Intraosseous infusion – the process of injecting directly into the marrow of a bone. It provides a non-collapsible entry point into the systemic venous system. This technique is used to infuse fluids and medication when intravenous access is not available or feasible.
Bones do not respond to local anaesthetic so it is extremely painful unless the person is unconscious and it has to be completely sterile like a surgical process to reduce the risk of infection. Usually IO is done only in the event of major trauma.
Now she should become stable but please ring us if anything crops up. Once the second bag of fluids finish, you can attach the third and let it run overnight (as professor advised when they called him)
He illustrated the bag switching process and cautioned about Air Embolism – If air gets into the syringe or IV medication bag and the line runs dry, air bubbles can enter your vein. These bubbles then travel to your heart or lungs and block your blood flow posing severe problems such as heart attack or stroke so you have to monitor the drip.
By now the bolus of medication infused effectively surged a force of life into my vital organs. As the pitch blackness from an under realm slowly unclouded and my eyelids blinked in disorientation, synchronized voices reverberated with relief. Alhamdulillah the medics vigilance of recognizing an absent pulse followed by immediate intense efforts of pumping life into my veins proved successful…
A date etched into my mind and a time I will never forget
From the brink of death to a brand new life now being set
Four weeks later it still feels surreal to be here relating an epic tale of survival
Subhanallah! The resurgence of a beating heart is a phenomenal miracle