Free Memoirs of an Emergency Nurse by Elizabeth Nicholl Page A

struggling for breath, doctors around her poked and prodded her arms to try to find a vein so drugs could be given. She had been stabbed a few times as the doctor couldn’t find a vein and she was now sweaty and couldn’t keep still.
    She was given steroids to stop the inflammatory process and blood was taken. She was talked through the process but she already knew what the routine was, she needed support.  I talked to her to calm her down. I don’t think Anna was listening but calming words produce less distress so I talked her through what we were doing, and told her that the doctors were looking at her blood results.
    Asthmatics can retain carbon dioxide in the lungs which doesn’t help matters, because they essentially aren’t clearing their lungs properly. Oxygen struggles to get in and carbon dioxide struggles to get out and usually a blood gas sample is taken to determine if this is occurring. It is a painful experience to get blood from the artery and is usually taken from the wrist. This caused Anna to panic even more and my reassuring words were wasted. As the doctor took the sample, she squeezed my hand. The sample was taken and the syringe with blood in it enclosed in ice and staff ran upstairs to ICU for the reading from the blood gas machine.
    Anna was becoming tired, she lay back on the pillow with her flopped sideways from exhaustion. The high flow oxygen continued. I let go of her hand to get a wet cloth to wipe her sweaty forehead and she woke up immediately as if her support had left her. I reassured her again and her eyes told me that she had confidence in me and my comforting words and didn’t want me to go. Her breathing remained laboured, her respirations per minute were now twenty seven down from thirty four. Normal adults would be approximately twelve breaths per minute, so she was still breathing really fast.
    The medical team had the results back and it concluded that Anna was retaining carbon dioxide and despite the drugs we’d given to dilate her lungs, her condition wasn’t improving as we’d hoped it would..  Radiology was paged and they came to give Anna a chest x-ray in the resuscitation room. Her medical case notes were huge and tied with stretching elastic bands.  Three sets were brought for this twenty three year old woman; her notes told me she’d had numerous medical admissions and treatment for her asthma.
    She became agitated with the oxygen mask around her mouth. I’d put on a nasal cannula around her nose and calmed her down so that she kept the mask on her face. The medical registrar had organised a high dependency bed on Intensive Care and I told Anna I was going to get her ready. I fastened an ID band around her wrist making sure it was loose enough if they wanted to take more arterial gases or put more lines in.
    I’d called one of her relatives and they were on their way. We got the go ahead that the bed was ready in ICU and, after photocopying her notes and making the machinery portable, we were on the move upstairs. I’d measured Anna for an airway and slipped it onto my pocket. I knew from other transfers it always pays to be prepared. Onetime we were transferring a patient to the medical assessment unit and the patient stopped breathing. The three quarter mile journey to the other side of the hospital was isolated and I just said “Run.” It was too far to go back. Luckily, the rush of cold air hitting the patient and a quick sternal rub from me started the patient breathing again.  The staff back in the ward were oblivious to my need in the long corridor and were surprised when I told them what happened.
    Anna continued to breathe on her own, but at a rate that was still worrying. I was glad to transfer her off our trauma bed and onto the ICU bed. She was hooked up to their monitors and again sat up right but she still looked incredibly scared.  I handed over the patient to the ICU nurse and wished Anna all the best.  I hoped she would be alright, but I