Friday, October 21, 2011

Blood Transfusion

In the skills lab, we've been learning how to do blood transfusions. It's really very simple - for the most part, just like running a regular IV, just with a few extra bells and whistles. And of course, a million more risks.

One of which is hyperkalemia. Your blood cells are just full of potassium, and when blood is transfused, some of those cells burst, releasing way too much potassium into the plasma.

Before B died, she received a blood transfusion. I have no idea when, or how much. She was hemorrhaging from her lungs. That's all I know. When we were finally allowed in the room and they told us that they had done everything and she still wasn't getting better, that was one of the things the neonatal nurse practitioner said.

Her potassium levels are so high... so high her heart will slow down, down, down until it stops.

Asystole.

We let her die before that happened. When we made the decision, though, her heart rate was already in the 60s. The alarms kept going off. {120-160 beats per minute is what is normal, if you're not familiar.}

I don't know how high her potassium levels were. I wouldn't have understood it if I had known. I didn't understand anything, yet they put the decision of her life or death into my hands.

Every new thing we learn about that I was first exposed to that night takes me back. Makes me second guess whether I made the right decision. Because really, I made that decision with hardly any information. I had medical advice and that was all. No background knowledge to speak of.

Someday, I want to see her chart. I want to know what happened before they let us into that room.

But I'm afraid. Really, very afraid. I know too much now. I'll know if errors were made, or if I made the wrong decision. If I could have had them do something, anything, to save her life.

I looked up the number for medical records at that hospital just the other day. I haven't called it yet. I want to get her records sent to me - I don't know how long they keep them readily accessible {probably a long time, but still}. I'm nowhere near ready to read them, though.

Maybe when I graduate. Maybe when she would have turned 5. That's a nice round number.

When she would have turned 5, I'll know how to save a life. I'll be able to see more clearly that vague, vague line where enough is enough. I'll know for sure if her medical team - and if I - did everything, everything. I think we did, but I'm afraid. So afraid that we didn't.