PREGNANT

"Doc. Buenavista, here are the names and details of the following interns for tomorrow." Doc Coldwell said. He gave me a clipboard that so many of paper. Probably 50 plus intern are going here next week.

"Yes Doc" i said and left his office.

I hurriedly find her name.

Name:Anastasia Xyn Ford

Birthday: 08/05/1998

Age:22

Medical school: manila theological

college-college of medicine

Suma cum laude (1.20)

Live in: Risk residence

"Hmm, I'm 1 year older than Anatasia, and she's smart too, but why her nickname is far from her real name? Can it be tasia, or athasia? weird." I whispered to myself while in the elevator.

When the door finally open, Doc Rhys appeared in front of me and he's panting.

"Let's go Doc. Buenavista, there's a pregnant woman coming..." I look at him with confuse in my face.

"But she's involve in car accident." He continue, my eyes widened and I immediately ran out to the patient, and Doc Rhys follow me.

"There." i pointed the hybrid room.

"1.2.3!" We lift the pregnant woman to lay her down on bed, with the help of other nurses, paramedics and Doc Rhys.

Nurse put the oxygen mask on patient, and i keep compressing her chest.

"How long has she been in cardiac arrest?" Doc Rhys ask paramedic.

"She was unconscious when we saw her in her car until we went here in hospital Doc..." paramedic said .

"15 minutes Doc. Rhys" I said as I continued to compressing her chest.

"I will check her heart rate when the monitor is fixed, Doc." The head nurse said, nurse Jaz.

"Give her 1mm of epinephrine through an IV line in every 3minutes." Doc Rhya said in nurse.

"I need someone to take over me!" I yelled and some of nurse take over me.

"ET!" (Endotracheal tube) Doc Rhys said, and nurse gave that to him.

"Nurse Jaz pull her womb in to left as much as you can." said Rhys to the head nurse and he inserted the tube into the patient's mouth.

Endotracheal intubation is a procedure by which a tube is inserted through the mouth down into the trachea (the large airway from the mouth to the lungs). Before surgery, this is often done under deep sedation. In emergency situations, the patient is often unconscious at the time of this procedure.

"The monitor is connected doc." head nurse said.

nurse stop CPR the pregnant woman and she look at the monitor. (heart rate monitor)

"Asystole!" Doc Rhys and i said.

Asystole is the absence of ventricular contractions in the context of a lethal heart arrhythmia (in contrast to an induced asystole on a cooled patient on a heart-lung machine and general anesthesia during surgery necessitating stopping the heart).

"Probably, she's 36 weeks pregnant." Doc Rhys and i just answer him with a nod.

"Her fundal height is about 36cm." Head nurse said.

"The baby is big enough to have viability." I said.

"Let's check the fetus if still alive." Doc.Rhys said.

"Fix it to 20cm." Doc. Rhys said.

"Let me see the sonogram."I said.

"Her shirt!" Head nurse said. And the nurse tore the patient's clothes enough to see her whole belly.

Nurse put ultrasound gel on pregnant's belly and Doc Rhys laid the transducer probe on her belly too.

"The fetus is alive... But the heart rate is too slow." Doc. Rhys said.

"We need to do a c-section Doc. Mj." Doc. Rhys said.

"C-section?"

"Hmm..." he nodded. "I think we need to conduct a PMCD." Doc. Rhys said.

"Okey" head nurse said.

"Continue to compress the patient's chest, so that the blood does not reach the placenta." i said nurse who compresses the patient's chest.

"If we do not remove the child from the patient's abdomen, they may both die." i said.

"Nurse Jazz we need a life support kit for newborn infants and a NICU (neonatal intensive care unit)." Doc. Rhys said.

neonatal intensive care unit, also known as an intensive care nursery, is an intensive care unit specializing in the care of ill or premature newborn infants. Neonatal refers to the first 28 days of life. Neonatal care, as known as specialized nurseries or intensive care, has been around since the 1960s.

"We have the life support kit already...Care & Cure Hospital agreed to let us use their NICU..." nurse said.

"....And I will take the baby there." i nodded.

"Get ready to do a neonatal resuscitation." doc Rhys said to nurse Jaz.

Neonatal resuscitation also known as newborn resuscitation is an emergency procedure focused on supporting the approximately 10% of newborn children who do not readily begin breathing, putting them at risk of irreversible organ injury and death.

"Stop performing resuscitation as soon as the baby is out, and run to the ambulance"

"Who's going to do a surgery?" i ask.

"I'll do it." Doc Rhys said and smirk.

"Okey I'll assist." i smirk too.

"Nurse Jaymie, please have the surgery tools already." nurse Jaz said to some nurse.

We put on mask and surgical gown.

"Don't stop the cpr." i said while we putting on glove to my hands.

"Scalpel." doc Rhys held out his hand, the nurse immediately put the scalpel on his outstretched hand.

"CPR 19minutes and counting."

"I'll cut the skin vertically and uterus transverse(horizontally)." Doc. Rhys said.

"Cutting in." And there was blood coming out so I asked for "Cauze."

I patted the cauze on the cut so that the blood would not spill....

"I'm into the abdominal cavity!"

"Hold tight." Sabi niya pa.

"1,2,3!" After counting to three we open the patient's belly. enough for the baby to get out.

"I see the womb." I said.

"Give me the Richardson retractor." Doc Rhys said and she gave to his and me.

Richardson Retractor is a 9-1/2" long retractor that can be used during procedures, such as chest or abdominal, to grasp soft tissue using the curved blade. Several widths and depths of the blade are available in order to suit the different surgical needs. The Richardson Retractor is available with a grip handle, a lamb handle, or a standard hollow loop handle.

We grabbed the Richardson retractor and pulled it to make the hole in her stomach grow bigger

"I'll cut the womb."sabi ni Doc. Rhys, habang hinihiwa iyon ay may lumalabas na tubig. Doc Rhys said while he's cutting her womb theres a water comes out.

"Remove the tools!" Doc Rhys said.

He inserted two hands inside the patient's womb and carefully pulled the baby out of there.

"Baby out: time is 19:24." nurse Jazz said.

"Scissor." After the nurse handed over the scissors, he cut the umbilical cord and gave it to Nurse Jazz for cleaning.

While Doc Rhys takes the placenta and sews on the patient's stomach, I go to the baby.

I listen to the baby's heartbeat using a stethoscope, his heart beat is gradually weakening. SHIT!

"Please,please,please,please." i reapeted said while im pressing the BVM.

"Its not working, let's intubate!" I yelled and nurse immedietly gave IT.

when I put IT in the baby's mouth it suddenly ..... cry.

"UNGAAA!UNGAAAA!UNGAAAA!" thank god, in that second of time, no one spoke. Just a sound of crying baby and the monitor. I sat down and looked at Doc. Rhys, we both nodded.

the nurses immediately wiped it off some of blood and they wrapped it the baby on a small towel.

"The ambulance is out, Care & Cure Hospital is 20 minutes away Nurse Jazz." Doc. Rhys said.

"Yes, doc. I will take care of the baby." and then she left with the baby.

rhys touch the pulse of the patient's neck with his two fingers

"ROSC!" Rhys shout. I feel relieve.

Return of spontaneous circulation (ROSC) is resumption of sustained perfusing cardiac activity associated with significant respiratory effort after cardiac arrest. Signs of ROSC include breathing, coughing, or movement and a palpable pulse or a measurable blood pressure.

"The mommy is back! The patient is back!" Doc Rhys shouted and he jumped because of happiness! I smiled at him.