We were in a very peculiar situation since the last week.
Our hospital is in a very high snake-bite prone area. Therefore, we keep about 40 vials of the Anti-Snake Venom separately for our staff use. Unfortunately, since the last 2 weeks, we faced difficulty procuring the ASV. And to make matters worse there was no dearth in the the number of our admissions of patients with venomous snake bites.
About 5 days back, I was relieved to know that one of our suppliers agreed to give us about 120 vials of ASV. He promised to come on Friday last. Unfortunately, he did not come. And on Thursday night, there was a snake bite victim on whom I ended up using 16 of the 40 vials kept of our staff. I was in a fix and I prayed that there should not be any snake bite victims over the weekend.
Meanwhile, the supplier phoned up and confirmed that he would arrive surely on Monday. I somehow got hold of 5 more vials of ASV from the local retail pharmacies – most of them had none or at the most 1 or 2. And we had one more snake bite victim on Sunday night – and I used up 8 of the vials.
I was in for trouble – the supplier’s train got cancelled on Monday. So, I was looking like a fool with 11 vials of ASV and I knew that I could only pray hard. And that’s what I did. The supplier called me and confirmed that he had got a ticket for Wednesday, the 12th October.
But, I had almost 48 hours to get through with only 11 ASV vials with me. Then, out of the blue – the good Lord gave me a thought. Dinesh, our engineer had gone along with Sr. Rita, the Nursing School Principal to Ranchi. I asked Dinesh if he could just try to scout for some vials of ASV. I was glad when he could get a total of 15 vials from different places.
And today, I knew that the thought of getting some more vials happened only for a little girl who came at around 11 am today with absolutely no respiratory effort. She was apparently bitten by a cobra. Later we found that the hematological parameters were also awry – so conclusion that it must have been a large krait.
We intubated and mechanically ventilated her. 8 vials of ASV were flowing into her veins in no time and 8 more went in over the next 4 hours. It was good to see her conscious and sitting up comfortably when I left hospital in the evening.
The incident had a very simple message to me – on whom I should be trusting. There is a verse in Psalms 20 – v7. Some trust in chariots and some in horses, but we trust in the name of the Lord our God.
The supplier confirmed just now that he is finally in the train on his way to NJH. I’ve asked Dr Nandamani to go ahead and use the remaining 15 ASVs if there is a need in the night. I sleep peacefully in full faith that the Lord is trustworthy.
Dear Jeevan,
ReplyDeleteThanks for your sharing. It is sufficient to use a low dose ASV regime for purely neurotoxic snake envenomations (with only 10 vials maximum). This is pertinent as procuring ASV is becoming more and more difficult and the cost per vial is Rs 450/-. So 10 vials itself is Rs 4500/-( a big amount for a poor patient)
Philip Finny
Dear Jeevan,
ReplyDeleteGreat to hear of the Lord's provision! Praise the Lord!
With love and prayers,
Santosh