A Day in the Life of an Emergency Department Doctor: Navigating the Storm

By Evans Mutia

Every day presents new trials in the emergency department’s ever-changing landscape. I want to recount a recent experience that profoundly impacted me.

One seemingly serene evening, the ER was abruptly thrust into chaos by the urgent arrival of a middle-aged man in critical condition. His gasps for air were accompanied by alarming vital signs: a pulse racing between 150-170, a respiratory rate in the 40s, blood pressure soaring to 220/105, and oxygen levels plummeting to a mere 54% on room air. Trouble was an understatement. His airway teetered on the edge of collapse, prompting our immediate decision to put him on a ventilator.

Time was of the essence, leaving us no room for the customary approach of gathering detailed patient history. Nevertheless, his wife provided essential information – he had struggled to breathe and coughed up blood after a massage nearby. Adding to the complexity, he possessed only one functional lung due to a past surgery and lingering lung damage from a previous bout with COVID-19. Astonishingly, he had no other chronic illnesses and wasn’t on regular medication.

Despite our best efforts, we couldn’t stabilize him. A desperate struggle ensued, complicated further by the incessant wailing of the ventilator alarms. In a moment of despair, we sought help from a team of specialists. Despite our collective expertise, the patient’s condition deteriorated, culminating in three cardiac arrests, and tragically, we lost him.

This experience, undoubtedly one of my most challenging, left me with lingering questions and emphasized the intricate nature of emergency care. From this ordeal emerged valuable lessons:

  • Urgency and Accuracy: Emergencies demand swift and precise assessments; timely decisions can mean the difference between life and death.
  • Communication and Collaboration: Clear communication and seamless teamwork among medical staff are paramount. Collaboration ensures a holistic approach to patient care.
  • Adaptability: Emergencies rarely follow a set pattern; medical professionals must swiftly adapt their strategies based on real-time developments.
  • Thorough Information Gathering: Even amidst crises, gathering comprehensive patient history is crucial; it can offer vital clues for accurate diagnosis and treatment.
  • Seeking Specialized Assistance: Recognizing our limitations and promptly seeking help from specialized colleagues can significantly impact patient outcomes.
  • Emotional Resilience: Emotional resilience is vital in coping with the inherent stress of emergency care. Learning from difficult situations is essential for personal and professional growth.
  • Continuous Learning: Post-case analyses provide valuable insights, ensuring ongoing improvements in emergency care protocols and practices.

These lessons serve as a poignant reminder of the dynamic nature of emergency medicine, emphasizing the importance of education, collaboration, and an unwavering commitment to patient well-being.

Emergency Medicine Kenya Foundation