Cardiac and respiratory arrest as a bacterial infection consequence

Casting
Robot: Tony
Mother- Yuselmy Santoyo
Paramedic- Esther Mendoza
General Practitioner- Fabiola Herrero
Junior Doctor- Jenifer Cruz
Staff Nurse Cleminia - Sabrina Fajardo
Consultant Dr. Clark (pediatric infectious disease specialist) Alonso Ojeda
Consultant Dr. Sergei (cardiologist) Alan Duarte
1st Scene
Esther: Good afternoon, we are about to perform our Medical English final
project which is named Cardiac and respiratory arrest as a bacterial infection
consequence in which Tony is being menaced by a mysterious disease, the
medical crew and Tonys mother will get in charge of the situation and will fight
anything that comes across. Our Medical cast is integrated by the Robot Tony;
Yuselmy Santoyo will interpret Tonys mother, the paramedic interpreted by
Esther Mendoza; the General Practitioner by Fabiola Herrero; the Junior Doctor
by Jenifer Cruz; the Staff Nurse Cleminia by Sabrina Fajardo; the Consultant Dr.
Clark who is a pediatric infectious disease specialist will be played by Alonso
Ojeda and Consultant Dr. Sergei who is a cardiologist will be played by Alan
Duarte. We would like to thank our teacher Adelaida Poveda Gutierrez and all
the members of MONTAGNES Simulation Center. We hope you enjoy the play.
2nd Scene
Plot: Everybody is in the Accident and Emergency Department: The paramedic,
the mother and the Junior Doctor are surrounding Tony. The General
Practitioner, Consultant and the Staff nurse Cleminia are chatting at one side
with each other. Meanwhile the Junior Doctor is clerking the patient. The
mother realizes that something is wrong with Tony and starts calling for help.
Tony needs Cardiopulmonary Resuscitation (CPR). The Staff Nurse Cleminia, the
GP and the JD run to help, the paramedic asks the mother to stay aside, and
they all proceed to perform the CPR.
Mum- He has been feeling so ill for so long, and now this! When is she going to
get better?

JD: Doctor Clark is a pediatric infectious disease specialist; he will know how to
help your daughter.
-The GP and Dr. Clark start to talk about what Tony could haveDr. Clark: (to the junior doctor) have you checked his micturition? Has he
passed any stools? Any signs of temperature?
JD: Doctor, he just arrived, I... (She is interrupted by Dr. Clark)
Dr. Clark: Well then, did he entered walking? How was his gait?
JD: The paramedics got him here, he entered in a wheelchair
GP: (changing the subject as he sees Dr. Clarks questions are getting
nowhere) do you think his seizures could be caused by an infection?
Dr. Clark: Yes, of course they could, but the fact is that nobody has a hint about
what kind of infection it could be. (He takes the patients medical history and
starts reading it) he has been under household observation and his mother is
checking on him all day long.
Nurse Cleminia: (Directly to Dr. Clark) the patient has a 38C fever and it wont
go away, he claims that his muscles feel just as when he has played football a
long time, it must be numbness, and there is something black on his armpit
Paramedic: (Shouting from Susies side) Nurse Cleminia, the patient is about
to have another seizure, he is starting to shake, his eyes are going blank, hurry
up, he has just stopped breathing
- The GP pulls the Junior Doctor aside to know what information he found
relevant when he clerked the patientGP: I need to know more details about Tony, (holding the medical history
papers) these dont tell me anything I need to know, Tony even seems to be
healthy...
JD: I asked his mother, everything that could come to my head. I checked every
reflex, and it all makes me think that he is not sick. The reason why the
ambulance brought him here was because he, all of a sudden started to sweat
more than usual, had blurry vision and he fainted.
GP: No! That wouldnt happen because of his celiac disease, we dont have
enough information, the patient is the same as when he came in, or maybe
worse.
JD: There is something he says even when he appears unconscious...
GP: What is it?

JD: His mother says it was a big disappointment to hi, its about a dog that
apparently came out of the blue and seemed to have had some hard days
leaving on the streets, and she adopted it and even named it, though the same
day at noon
GP: We need real information, not some kind of lovely kids fairytale story
-The Staff Nurse Cleminia interrupts abruptly looking very distressedStaff Nurse Cleminia: Doctor, I think we had better call a cardiologist, Tonys
heart is fibrillating and he is starting to have peripheral oedema as if his right
heart was failing.
GP: Go look for Dr. Sergei, he will know what to do.
-The staff nurse Cleinia goes outGP: (She tells the JD) you may continue, but please skip the fairytale details
JD: As I was saying, well, the dog didnt really come out of the blue, it had an
owner who showed up and took the doggy away, thats why she keeps on
saying Doggy
GP: Doggy? All right! That lets us know that his speech is normal, now lets
keep on questioning the mum.
-The cardiologist (Dr. Sergei) enters the roomDr. Sergei: I have been told that there is a patient here having cardiac
problems, I may offer my help to whoever needs it.
Paramedic: Tony has not been doing well, we believe that he is having right
heart failure.
Dr. Sergei: Yes, I can see the peripheral oedema, for how long has there been
swelling?
Mum: Yes doctor, help! (She exclaims in a very gallant way)
Dr. Sergei: No problem old lady, Ill see what I can do.
Staff nurse Cleminia: The peripheral oedema started twenty minutes ago.
Dr. Clark: His heart rate, about one hour ago, was stable, with about 74 beats
per minute, now his heart beats are irregular, as in arrhythmia.
Dr. Sergei: Is it a pitting oedema?
Paramedic: Sure it is, I can clearly see the pit when I push my finger into the
swelling.

Dr. Sergei: Let me perform an examination, does she have any orthopnoea?
Mum: What is that Dr. Sergei?
Dr. Sergei: Orthopnoea is to be breathless when laying flat
Mum: Breathless as me? I mean, as he?
Dr. Sergei: Yes.
Paramedic: No he doesn't have orthopnoea.
-The cardiologist proceeds to carry out the medical examination and goes
through the four stages: inspection, palpation, percussion and auscultationDr.Clark: What do you think is causing the heart failure?
Dr. Sergei: Im afraid the heart failure is the result of septicemia, anything he
has must be cured as soon as possible, otherwise we will have to perform a
mitral valve replacement.
Mum: (almost crying and very worried) make his health improve doctor, he is
my only kid.
Dr. Sergei: Ill do my best.
-The GP gives a look to the JD to keep on doing the research. The GP and JD
take the mum aside and try to inquire about the day Tony found the dogGP: We are not sure till now what can Tony have, we need to know any detail
about him, and anything that you can tell us is useful.
Mum: I have told you all, I swear I dont let him go anywhere, we are together
at home all the time and Im watching him all day long.
GP: Yes, we know you are very careful, but we need to know more about the
day Tony found a dog.
Mum: The dog, yes, he seemed to be so happy to have a friend, I hadnt seen
him so happy for a long time.
JD: Maam we need to know if Tony started to feel physically something new,
any new symptom.
GP: Some sort of allergy, to any kind of fur.
Mum: No, not at all, we had three cats, two rabbits; he even has a four year old
hamster in his room.

Dr. Sergei: You mustnt pass over any kind of information, there is a tiny little
animal causing your daughters heart to fail.
-The paramedic interrupts Paramedic: When I brought Tony to the hospital, if this can help you in any way,
I felt a bubo under his armpit, it could be a cancer sign.
(While the paramedic is talking, Dr. Clark comes to listen what they are talking
about)
Dr. Clark: I dont think this is any type of cancer, he wouldnt have these
symptoms, this seems to be sort of a (The staff nurse Cleminia interrupts)
Staff Nurse Cleminia: The patient is stable; I think its about time to do some
more tests, maybe do a blood culture, a blood stain, sputum culture, urine
culture...
GP: Take a sample of the bubo he has under his arm, a biopsy might be helpful.
Dr. Clark: I suggest we do an MRI if we still dont find anything in the lab tests.
-The staff nurse Cleminia goes to take Tonys samples and leaves the room
afterwards.Paramedic: If anything goes wrong maybe we will have to cut his arm and leg
off
Everybody in unison shouts NO! The mother passes out.
JD: How you dare to say something like that!
The GP, Dr. Sergei and Dr. Clark look to each other and in unison say The leg?
Paramedic: Well yes, she seems to have another bubo in his groin, and this one
looks blacker.
-Everybody but the paramedic, who is treating the fainted mum, goes to see
Tony and see the two bubos that have grown out of his armpit and groinDr. Clark: So, there are two bubos on Tonys body, where most of the lymph
nodes are, these seems to be The Plague.
GP: But therefore, Tony must have a flea, and he has been in no other place
than his home.
Dr. Sergei: Then something must have gone to him, and caught him while he
was in her home.
Dr. Clark: Yes, this is medicine, coincidences dont exist here.

Paramedic: Wait, werent you talking about a dog which had been sniffing on
the streets for days?
Mum: He played a long time with the dog, hugged him as if it were a teddy
bear.
GP: (to the JD) go and search for information about the plague
-The staff nurse Cleminia comes back inNurse Cleminia: I have the sample results (she gives them to Dr. Clark) There is
a patient who has just been admitted to the hospital, his medical history reads
that he had a dog that was infested with fleas, the patient has the same
buboes all over his body, and also the same symptoms as Tony, though he just
died because of the septicemia.
Dr. Clark: Nurse Cleminia, check for fleas on Tony
Mum: Doctor, please save my son!
-Dr. Clark opens the envelope and starts to read the results (the mum seems to
be feeling better and starts standing up) The GP approaches the consultant and
sees the test resultsThe junior doctor comes in saying out loud
JD: I think I know what (Stops suddenly because she sees everybody
gathered looking at something)
The paramedic is already there reading the results
Everybody sees straight into the camera muttering Then he has
The camera focus on the nurse who shouts A FLEA
Then everybody still where they were says YERSINIA PESTIS

THE END