Every morning when I pull open the door to the intensive care unit (ICU), I need to take a deep breath. Walking into that room means the day’s battle has begun.
My name is Yan Ying, and I am a nurse at a hospital in Danjiangkou, Hubei Province, where I have worked in the ICU for three years.
The care of critically ill patients is complex and trivial, requiring accurate judgment at every step and consuming both physical and mental energy, but my mission is, to put it simply, to
To take care of the patients on hand and hand them over alive to the next shift of medical staff when the shift changes.
Danjiangkou is located in the middle and upper reaches of the Han River, in a mountainous area, sandwiched between the Wudang Mountains and the remaining veins of the Daxiang Mountains, and is the core water source area for the South-North Water Diversion.
For more than 20 years, I have seen too many lives come to an abrupt end in the hospitals of this small inland county.
Because of the lack of both knowledge and economy, life here is sometimes as thin as a cicada’s wing, broken by a gentle pinch of external force.
Late at night, the ambulance brought a bridesmaid
Ning Xiaomei was 22 years old
Alcohol poisoning, in ICU for 8 hours
At eleven o’clock late at night, Ning Xiaomei was quickly pushed into the ICU door by the pre-hospital emergency ambulance when we had just vacated an empty bed.
The heavy doors slowly closed, and for a moment, I saw the very anachronistic dress code of the people accompanying me through the doorway.
Women in wedding dresses, men in suits, and a few guys in white shirts and pants.
The ICU door was closed, along with their eager eyes.
I secretly muttered: “What is this group of people doing? “Without thinking much about it, I quickly established intravenous access.
Later, the colleague who followed the ambulance out, told the story.
Xiao Mei is a person from a neighboring city, sweet-looking, was asked by her girlfriend to be a bridesmaid in our city. At the wedding banquet, several groomsmen surrounded Xiaomei and kept toasting her, she was confident that she could drink, but she drank and fell unconscious.
When 120 arrived on the scene, Xiao Mei began to vomit blood, frightened the couple. The original lively and joyful wedding party turned into a frightening hospital emergency tour.
Usually, there are three periods of intoxication: the euphoric period, the ataxic period, and the coma period.
Xiao Mei had already reached the third period, and combined with stomach bleeding. Due to unconsciousness and post-drinking vomiting, she is prone to misaspiration, which can lead to pneumonia and even evolve into organ failure and life-threatening.
Considering Xiao Mei’s condition and age, we did not immediately put in a urinary and gastric tube, but chose to observe for a while.
This would make Mei feel better, but it also meant that the nursing workload became enormous.
The doctor told us again and again to closely monitor her pupils, blood pressure and urine output, and to keep her airway open.
In the silence of the summer night, my colleague and I made a careful plan of care.
At 2:00, we measured blood pressure, observed pupils, turned and buckled her back, and wiped the filth from the corners of her mouth.
At 3:00, we pushed in a wake-up call and drew blood to track her kidney function.
At 4:00, change her contaminated diaper, assess urine volume, and make nursing records ……
From eleven o’clock at night to seven o’clock in the morning, my colleague and I did not close our eyes all night to stop the bleeding, replenish the fluid, restore the circulation, stimulate the waking up and protect the brain cells ……
It was dawn when Xiao Mei finally woke up. Her cheeks regained their rosy color and she also recognized her bride who was crying with joy.
The doctor on duty, who had stayed up all night, looked down and asked Xiao Mei, “How do you feel now? “
She replied with a confused look on her face, “Nothing, I’m fine.”
She also turned her head and asked the bride, “Why are your eyes so red? “
The doctor on duty let out a long sigh, turned to me and said.
“It seems that her brain cells are not damaged for the time being. “
The next day, Xiao Mei came out of the intensive care unit with a relaxed look.
Our eyes “back from the dead”, in her case does not seem to be a big deal.
The girl who drank dichlorvos
Li Xiaohua 7 years old
Suicide by pesticide, 5 days in ICU
In the ICU of the county hospital, I have seen many people who took pesticides to commit suicide, some because of emotional entanglement, some because of the conflict between mother-in-law and daughter-in-law. Pesticides are too easy to obtain.
Some of them made it through, some didn’t. But I’ve never seen a 7-year-old drink pesticides.
Her name is Li Xiaohua and she is in second grade. To make ends meet, most people here choose to work outside the home, and Xiaohua’s parents have taken this path, leaving her at home with her brother, raised by her grandparents.
When I took over the shift, Xiaohua had already had her stomach pumped, a tracheal intubation in her mouth, various tubes in her body, and an antidote – atropine – coldly pushed by a micropump.
In communication with the parents, I learned what had happened.
Xiaohua and her brother participated in a school calligraphy competition together, and Xiaohua won the first prize, while her brother won the third prize. The grandparents, however, only praised the younger brother and promised to take him to the market at the weekend to buy new clothes. The countryside is heavily patriarchal, and a sumptuous table of meals is only for the younger brother.
The later story must have been guessed: Xiaohua found the pesticide bottle at home and drank it. The bottle had three words written on it – Dichlorvos.
In the ICU, Xiaohua’s pain was evident.
Because of the abdominal pain, she had spasms and convulsions. The cannula in her throat was hard and straight, and the pain was self-evident. Atropine dilated her pupils to 5 mm, and the nurses on each of our shifts had to record her pupil size.
Each time we looked into her pupils with a torch in hand, those big, innocent eyes blinked hard, as if trying to express something. To prevent her from unconsciously grabbing off the tube, we used restraint straps to tie her hands. However, she was getting less and less quiet.
“What’s going on? “
Vital signs were stable, cardiac monitoring was not abnormal, and medications were not accumulating and poisoning. To find the cause, I brought in Hana’s parents in full armor.
Perhaps it was because they had not lived together for a long time, and the parents could not read their child’s eyes.
I pondered for a moment, untied the restraint belt on Xiaohua’s right hand, and handed her a pen and a cardboard. The child twisted and wrote down: “The air conditioner is off, cold. “
Everyone breathed a sigh of relief and immediately turned off the air conditioner and covered her with cotton wool.
Five days later, Xiaohua’s blood test indicators were basically back to normal, except for the hoarseness of the noise – but any patient who goes on a tracheal tube will have similar symptoms.
Her parents quickly discharged her from the hospital.
Because, the doctor told them, suicide is not reimbursed in all medical insurance.
We appeared to have saved Hana, but in the dark a girl’s fate may have been rewritten. As health care professionals, there is not much we can do.
A snake bile for a pair of kidneys
Zhang Fugui, 29
Eating snake bile raw, 16 hours in ICU
When he came to this room with walls on all sides and various instruments flashing, Zhang Fugui looked at a loss for words.
Zhang Fugui came to the clinic because of back pain, and after questioning, he learned that he had skinned a snake alive and eaten its bile in the morning.
After some laboratory tests, Zhang Fugui was screened for abnormal kidney function and was rushed to the ICU.
His features were correct and had a handsome meaning. For me, a person who is afraid of snakes, he dared to catch a highly venomous snake gagged with his bare hands, which naturally made me admire him a lot.
Had it not been for this occasion, I would have pursued more details, such as “where the snake will appear”, “how to keep it from attacking people, etc.” …….
Half an hour later, he adapted to the environment and began to chat with the clinical family members, he spoke excitedly, as if in the hustle and bustle of the market.
“Why do you eat snake bile? “
“I heard people say, this thing down fire! “
“Are you afraid? “
“Hey, afraid of what, since I was a child, what do not dare? The house is also poor and sinful, there is a what discomfort also do not go to buy medicine, get some grass root boiled water to drink to carry over! This time a sore throat, others said, snake gall bladder raw to eat good results, immediately ran to the mountains to catch one. “
“What is the taste? “
“Very fishy! “
Suddenly, his wife came in wearing a sterile suit and relayed to him the doctor’s words.
The snake bile he swallowed contains severe poison, which has now invaded the blood, and the function of the kidneys has also been lost, requiring kidney replacement, or hemodialysis.
She was still whispering something, but didn’t hear Zhang Fugui’s answer for a long time.
I was ambling around writing notes, when I suddenly heard Zhang Fugui come up with a sentence.
“Snake bile is really so powerful? Why do you say my kidney is broken? “
I stared at him, deliberated for a few seconds wording.
“You’ve had 3,000 milliliters of fluids from 7:00 a.m. to 1:00 p.m. now, but you haven’t urinated once, have you? “
He was stunned, unable to refute.
Some snake bile contains bile toxins, cyanide and other highly toxic substances, and once eaten raw, may cause acute renal failure.
The time for dialysis was precious, so we quickly transferred him to the department and sent the half-hearted Zhang Fugui to the nephrology department for further treatment.
However, colleagues in the nephrology department told me that he was discharged after the transfer, and his phone message was disconnected.
Maybe he never believed that “snake bile is that powerful”; or maybe he didn’t have enough money.
ICU work was still busy, and new patients were soon added to the beds.
Later, I was transferred out of the ICU and didn’t have to open the heavy door every morning under pressure, but those three patients are the ones I remember to this day.
They were taken care of by me and brought back from death, but I have no way of knowing what happened to them later in life.
At the beginning of my career in ICU, I was always frustrated with why human life is so fragile.
Later, I realized that what is more cruel than the lack of help is that some people’s fate has already written the ending.
(All characters in this article are pseudonyms to protect patient privacy)
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