Friday, December 21, 2012

Referred Patients . . .

Over the last 24 hours, we received 3 patients with Eclampsia. Something not common at NJH. After the first part of our Christmas celebrations, quite a few of us were very tired. It was a tough ask. 

2 of them had normal delivery and one had a Cesarian section. By God’s grace, all the 3 babies are alive although one is pretty sick.

Why I post this piece is to showcase a referral letter, rather slip of paper which was brought by relatives of one of the patients.

Here is it.

This is from one district hospital. To start with, this is incomplete treatment for eclampsia.

This patient whom we shall call SDt is quite lucky to be alive. SDt, who comes from almost 100 miles away started to have labour pain couple of days back. By early morning yesterday, the relatives realised that they need to take her to the nearby Primary Health Centre. They reached the PHC at around 4 am.

At the PHC, things turned for the worse after she started to have seizures. They did not have any Sphygmomanometer (Apparatus to measure Blood Pressure). She was referred to the nearest district headquarters hospital.

Doctors at the district hospital found out that she has high blood pressure. She was given couple of injections and was told to go to a higher centre. The relatives were told that she needs to be operated ASAP, for which facilities were not available. 

She reached us around late evening. By the time she reached, she was fully dilated and Dr Johnson did a forceps delivery.

She has improved quite a lot by morning.

I’m sure that she would have definitely done better if she was given Magnesium Sulfate injections at her first point of contact with healthcare. I hope things improve.

And of course, doctors would do better if proper referral letters were given to patients when they go to a higher centre. And I hope that the health department would do good by ensuring that there is some paper available in these places for documentation. 

Before I sign out, the shocker of the day . . .

This is the leg of a young lady who had eclampsia and was being managed elsewhere. After she delivered her child sometime around Diwali, she had apparently swollen up. Nobody who accompanied her had any clue on how the leg has got into this state. Another example of neglectof the woman in the Indian context.

You will not believe that the people who brought this lady was NOT ready to admit her. It seems that they have just come for a check up and suggestion from our side on how to proceed further.

They have already left with the promise to come tomorrow with the husband. Only God knows if they’ll come back. She needs an amputation as soon as possible.

When we see such a patient, my post on Geriatric Care in this part of the country looks a far cry. 

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