Glimpses of possibilities

Yesterday, Titus called me to say that they ran out of ventilators for patients. 

There were 4 patients who needed a ventilator at the same time. And with the the nearest ventilator 80 miles away, there was no other choice than to manually ventilate using a bag.  

Patient A, a 25 year old lady who came with unknown poisoning. She came with seizures and later had a respiratory arrest. She was on the ventilator for almost a day before she was weaned out.

Patient B, a 17 year old young man with organophosphorus poisoning. He was gasping when he came in. He  obviously took the second ventilator. 

Patient C, a 48 year old man who came in with a krait bite. In spite of being started on a high dose ASV, he went into respiratory arrest. When Mr. C came in, B and C were already in the ventilator. Mr. C was manually bagged for around 12 hours, when we felt that Patient A could be weaned out. 

Patient D, a 9 year old girl who came in gasping after a krait bite. She was intubated immediately and was bagged till Mr. B was out of the ventilator. 

Then, there was a patient E, a 12 year old girl who was rushed in from the local village after a krait bite. We gave her an option to go to a higher centre. They have rushed her to Ranchi. 

We did not have a bag to ventilate her if she had a respiratory arrest. Even, we were not sure of starting ASV as we did not have a bag to ventilate (2 patients were being manually ventilated) if she had an anaphylaxis. 

Such a situation puts us in a position where we need to seriously ask questions about expanding our resources - - both in terms of infrastructure and qualified personnel. 

To start off things, we eagerly wait for Dr. Roshine, the medicine consultant who'll join us on the 22nd, the coming Saturday. 

OP Poisoning

A common term in most of the emergencies of hospitals in South East Asian countries, OP poisoning stands for organophosphate poisoning. 

We had the worst OP poisoning case ever in the annals of NJH couple of days back. 

SHD, a 26 year old, mother of 3, had gulped down an entire 120 ml bottle of Malathion after a tiff with her hubby. When she arrived, we had to literally pour Atropine down her veins to ensure that she remained asymptomatic. It was only after we had given about 3500 mgs of Atropine over 24 hours that she stabilised. 

Over the next day, we had weaned her out of the ventilator. However, we were very sure that 'Intermediate Syndrome' was just around the corner. I prayed that it would happen when we are around during daytime. 

But, that was not to be. I was just getting ready to hit the bed when she went into respiratory arrest. Dr. Shishir was operating on a severe pre-eclampsia patient with fetal distress when it happened. 

By God's grace, we've been successful in getting her well supported. Again, the staff in ACU did a magnificent job. The presence of mind and diligence was all the more evident as there were 3 eclampsia patients in the ACU. 

The next 24 hours are going to be crucial. 

We request prayers that she will be completely healed . . . and of course, specialist advice is definitely welcome.