So there's nothing like getting my neonatal advanced life support training just prior to coming to Honduras and getting some first hand experience. I was woken up from my bed around 10:30ish pm by Rimas, the husband of the ER physician saying there was an emergency C-section. I rush over with 2 OB nurses who are here with a team from Oregan. The patient is a G1 lady at term with no rupture of membranes or previous problems during pregnancy. She came in with some contractions and when placed on the monitor had fetal heart tones less than 100. She was having deep variable decels that then turned into late decels, and the OB Dr. started making plans for C-section. Abby, the ER physician, did the anesthesia, which consisted of Ketamine and Fentanyl. I was with baby, accompanied by two veteran OB nurses. The baby came out deeply meconium stained, floppy, apneic, and bradycardic. We stimulated the baby and did deep tracheal suction that pulled up a decent amount of the aspirated meconium. Then we bagged the baby who was still apneic and bradycardic. When we are getting everything ready for intubation, the baby finally lets out a cry. YAY! The baby is still a set-up for infection after the aspiration, but when from APGAR of 3 to an APGAR of 7. Praise the Lord. David Davis would be very proud.
Sorry to all of you non-medical people who do not think my medical jargon is very interesting I thought that I would share. Josh will probably blog tomorrow about the rest of our Sunday which was very lovely. It included a Honduran church service and a hike to a waterfill with a spontaneous baptism. Stay tuned.
On a sadder note, my 70 year old patient with COPD and pneumonia is still in pretty serious condition. She has improved some, but I still worry every time I walk by her room, and she is struggling for her breaths. If we had a reliable ventilator, I would have already intubated her, but instead, we are giving her antibiotics, nebulizer treatments, steroids, and hoping for the best.
Scary stuff . . .
ReplyDeleteAgain, I really cannot imagine anyone being a doctor in the first place. And doing it somewhere without proper equipment . . . . All I know is that those people are lucky to have you there and are being blessed by the gifts that God has given you and J (that's the way it works, right? Other people are blessed by the gifts you have, they are not yours, they belong to other people). Great stuff! Keep up the good work (thus says the guy with absolutely NO medical training, you have all of us lay people impressed anyway)! ;-}