Day 49 Dalaguete, Cebu #DPC Intradermal skin injection, nebulizer, ECG assist, IVTT

Today was a fairly busy night in the ER.

The first patient was an infant that came in with a 39.9 degrees Celsius fever (103.8 degrees Fahrenheit). The doctor order paracetamol PO and kept the infant in the ER for a few hours for observation. The medication reduced the infants fever so the doctor told them to come back tomorrow. Normally, the doctor would order a UA and have them wait for the results, but since it was after hours, the lab technician was already gone and wouldn't be back until tomorrow morning.   

The second patient to come in was an older gentlemen suffering from breathing problems. I administered three rounds of sulfate salbutamol via nebulizer at fifteen minute intervals after completion of each dose. The nurse hooked him to an IV and I injected hydrocortison and cefuroxime via IVTT. Prior to injecting the cefuroxime, I performed an intradermal injection skin test to confirm a negative allergic response to the antibiotic. After the injections, I helped hook him to to an ECG and prepared the printed readouts for the doctor to interpret.

I also prepped the delivery room but it turned out to be a false alarm and the patient didn't deliver that night.

Day 46 Dalaguete, Cebu #DPC Nebulizer, Intradermal Injection

I worked he night shift today at the ER. At 3:00AM a patient came in with difficulty breathing. O2 was administered immediately by the nurse at 5mL/min. The nurse went to fetch the doctor and delegated the initial vitals to me. The vitals upon entry were as follows:

HR 120
RR 40
T 36.6 Celsius

Before I could take the BP the doctor arrived and told me to wait until he had an initial prognosis. From what I could make out in Bisaya, the patient has known food allergies and has had respiratory problems before, but she didn't recall eating anything that might have set off an allergic reaction. The doctor order Salbutamol via nebulization; three doses given at fifteen minute intervals after the completion of each dose. He then asked me to take the BP during the first Salbutamol dose. I measured her BP at 110/70; by this time her RR had decreased significantly and she was taking deep controlled breathes. The nurse hooked her up to an IV and Cortisol was injected via IVTT to help reduce the bodies stress by acting as an upregulator in an anti-inflammatory pathway. Since the cause of the constricted breathing was unknown, the doctor also order an injection of Cefuroxime (also via IVTT) to combat an early possible bacterial infection. The nurse asked me to perform an intradermal skin test injection before introducing the full dose of Cefuroxime.