Chapter 59
Chapter 59
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Translator: crow
Chapter Title: A One-Star Amusement Park (2)
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It felt like I'd just clocked in for night shift moments ago, but the kids' wails, the parents' anxious sighs, and the nonstop blaring of monitor alarms had worn me down until the clock hands were creeping toward 11 PM.
Just four hours had passed, yet my soul felt forty years older.
The pediatric ER was a miniature hell.
Kids seizing from fevers, kids wheezing for breath, kids with gastroenteritis vomiting and shitting like fountains.
And the parents taking all that pain into their own bodies, wailing right alongside them.
That's when it happened.
One of the station nurses spoke up.
"C-bed 5 is admitting now. One bed just opened up."
At that moment, Chief Lee Min-jae shot up from behind me and bellowed.
"Finally...! Finally, a bed's open!!"
I gave Lee Min-jae a hollow-eyed stare.
"Uh, is that really such a big deal?"
"A big deal? Right now, you must be out of your mind!"
Lee Min-jae clamped onto my shoulders and pointed down the hall.
"Remember how we crammed kids onto those makeshift cots in the hallway earlier? After seeing that mess, you think one open bed isn't huge? This is paradise! Now we're only at nine full beds! Down from 100% to 90%! This is a pediatric ER miracle!!"
His loud outburst made the nearby guardians shoot us uneasy glances.
"Doctor, could you keep it down a bit...?"
"Whoops!"
Lee Min-jae finally clocked the surroundings, cleared his throat, and straightened up.
"Ahem. Han Hyun-jae. Thanks to that last admission, a ray of light has pierced the ER. We should commemorate this miracle. The kids have settled a bit, so as chief, I'll treat you to a canned coffee. Follow me."
"Oh, thank you, sir."
Out front by the ER main entrance, the cold night air tickled my cheeks.
I peeled off my mask for the first time in hours and gulped down fresh air.
Lee Min-jae stood at the vending machine, feeding in coins.
Two canned coffees thudded down.
Ahh. This is why we keep going.
That's when it hit me.
Hmm, what's that...?
Across the street from the hospital.
The pedestrian signal at the crosswalk was definitely red.
But two people were blowing right through it, sprinting across the road.
In their arms: something small bundled in a blanket.
"Uh... uh? Sir, that..."
My voice trembled.
"Looks like a kid...?"
All the joy drained from Lee Min-jae's face.
The pair bolted toward the emergency center, yelling at the top of their lungs.
"Please save our son!"
The canned coffee slipped from my hand and hit the ground.
"Cyanosis...."
Lee Min-jae murmured under his breath.
Yeah.
The kid's lips and around the nose were painted blue, like someone had slathered on paint.
We sprang into action together.
"I'll take him!"
I rushed to the man and scooped the child from his arms.
The kid's body was limp, skin ice-cold.
How did such a tiny body get this cold?
I cradled the child and dashed back into the ER with Lee Min-jae on my heels.
"How old is the baby! When did this start!"
Lee Min-jae bellowed at the parents as he ran alongside.
"Two years old! He was fine until just now, then suddenly started breathing weird and turned blue...!"
"Set up a peds resuscitation bed, now! Hurry! Hurry! Call the on-duty pediatrician!"
Nurses scrambled to prep the resus room; someone yanked in a pediatric crash cart.
I sprinted toward resus, child in arms.
The weight of that little life felt like a thousand tons.
I gently laid the child on the resus bed.
"Hook up the monitor and get an IV line, quick!"
Nurses slapped ECG leads on the tiny chest and wrapped a BP cuff around.
Another nurse hunted for a vein on the kid's foot.
"The kid can't breathe! Airway first!"
Lee Min-jae positioned at the head and secured the airway.
"Ambu bag! Where's the damn Ambu bag!"
Cyanosis.
A sign the body's starved for oxygen.
"Sats! What's the SpO2!"
Lee Min-jae shouted. A nurse clipped a pulse ox probe on the kid's tiny toe.
All eyes locked on the monitor.
I swallowed hard.
80%? No, maybe 70s.
Worst case, 60s.
The monitor flickered.
Heart rate popped up: 150.
Then the SpO2 number finally appeared.
[ SpO2 : 85% ]
...
Silence fell.
I couldn't believe my eyes.
"...What the hell."
Lee Min-jae muttered blankly.
"85%? He's this blue and it's only at 85%? We're bagging oxygen and it won't climb! Machine broken? Swap the probe to the other foot! Hurry!"
The nurse fumbled the probe off and clipped it on another toe.
The monitor blanked out, then lit up again.
[ SpO2 : 86% ]
Everyone in resus froze.
The kid's lips were undeniably blue.
The kid was clearly struggling to breathe.
The body was totally limp.
Everything screamed classic severe hypoxia from oxygen starvation.
Yet the machine hovered around that ambiguous 85%.
Even with high-concentration oxygen forced into the lungs.
I shot Lee Min-jae a confused look.
He stared at the monitor in a daze too.
"Heart issue? Congenital heart defect? Severe pneumonia? Sepsis?"
The most nightmarish terms that flash through a doc's mind in a pediatric emergency spilled from Lee Min-jae's lips.
"No, that doesn't add up."
He shook his head.
"Probe! New one! Grab a fresh probe!"
At his shout, a nurse bolted out of resus in a panic.
"Mom! Dad! Snap out of it and listen! Right before the kid got like this, what happened? What'd he eat, bump into anything? Anything at all! Even tiny details!"
"B-baby f-food...."
The mom answered in a quivering voice.
"We pureed carrots and spinach for dinner and fed him, but mid-bite he started gagging...."
"Baby food? Gagging?"
Lee Min-jae's eyes flashed. A new possibility.
"Aspiration?"
He muttered, rushing back to the head of the bed.
He grabbed a pediatric laryngoscope and peered carefully into the mouth.
Checking for food chunks blocking the airway.
But the throat was clean.
He suctioned deep—only clear saliva came up.
"Not aspiration... Then what the hell!"
Lee Min-jae ruffled his hair roughly.
Just then, the nurse dashed back with a new pulse ox probe.
Lee Min-jae snatched it and jammed it on the toe.
Eyes glued back to the monitor.
[ SpO2 : 85% ]
No change.
Lee Min-jae whipped out his phone.
"...Peds on duty? Yes, this is Lee Min-jae, fourth-year EM resident. Got a 24-month-old in peds resus with cyanosis... But SpO2 is stuck at 85. Even with continuous oxygen. No, you heard right."
With the fresh reading still crap, I had no reason left to hesitate.
*This is beyond my brainpower.*
I pressed my stethoscope to the kid's chest like I was listening to breath sounds and summoned the blue interface.
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Title: Guys pediatric ER super urgent atypical af
Author: HellKoreaSlave1
2yo kid cyanotic but SpO2 85%. Not machine error, not aspiration. Bagging O2 nonstop.
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I waited anxiously for replies when a new comment popped.
BloodClotIsHell: Suspect methemoglobinemia. History taken?
Met... what?
LatteIsJustWords: That's the one. Hemoglobin in the blood turns into a form that can't bind oxygen. Blood's circulating fine, but zero oxygen delivery. Kid's oxygen-starved and blue as hell...
CardiologyGhost: Mom give him well water or spinach or something?
Ah!
Cyanosis, weirdly fixed SpO2, and spinach-carrot puree.
Every clue screamed one diagnosis: methemoglobinemia.
I looked up.
Lee Min-jae had just wrapped his pointless call to peds and was pocketing his phone.
I opened my mouth cautiously toward him.
"Sir."
"What."
"What if it's that?"
"What."
"Methemoglobinemia."
Lee Min-jae's body went rigid.
"Uh... um... yeah... methemo... globin... what?"
He muttered.
Faint memories from med school hematology lectures were probably resurfacing in his head too.
Cyanosis mismatched with SpO2 readings. Nitrates. Baby food.
His eyes shifted from "What bullshit is this punk spouting?" suspicion to sheer shock in an instant.
"Huh? Huh?! Fuck, that's it!"
A belated curse of realization burst from Lee Min-jae.
He gawked at me and the kid on the bed in disbelief, back and forth.
"Hey, Han Hyun-jae! How the hell did you...!"