Tuesday, 2 June 2015

Vigilance and alertness saved the epileptic mother and her unborn child !

                                       

It was a lazy Sunday morning. After sweating out in the garden, I was having a leisurely shower when I suddenly heard my staff from hospital shouting, “madam, Sandra (name changed) is having a fit”. She was totally out of breath, as she came running from the hospital which is  a stone’s throw away from my house.  It immediately struck me that my pregnant epileptic patient Sandra and her unborn baby are  both in danger.


It took me 5 seconds to quickly wear my dress ( I always keep easy to wear dresses on the top rack, which is  quickly accessible and can be slipped on briskly in case of an emergency ). It took me just 1 minute to reach the hospital and when I reached the spot, I was breathing normally and fully composed, thanks to my regular  yoga training.


On my way, I was shouting instructions to each staff  to get things ready for an emergency. By the time I reached, I  had arranged for injection ready for epilepsy, an airway ready  to keep her breathing, ambulance ready with the driver in case of emergency transfer, oxygen mask ready with the multiparameter cardiac monitor  to check her BP, pulse and oxygen saturation. All this happened within the one minute span, while  I was walking towards the patient. Meanwhile, Dr Mani and the staff had lifted the patient on to post op bed. It helps when doctors are physically fit to help in emergency and  have the willingness to do anything to save a life.


Every second was important as two lives were at stake and time was limited, few minutes delay and both the baby and  the mother  will be in danger. She was made to lie on the side and airway was secured  by keeping her mouth open      (Initially we kept a towel in her mouth, which was the first object accessible to prevent her from biting her tongue ). We managed to give her the injection to stop her fits and she was unconscious by this time. 


The staff nurse on duty was nearly out of breath from lifting the patient, she had joined only one month prior in our hospital, so getting an iv line was not easy. I calmed her down and she did it very smoothly and got an IV line at the very first attempt and we started fluids fast, so that her circulation is maintained and baby gets enough oxygen for survival.


Parameters readings were reassuring as her BP was normal. Tachycardia (an excessively rapid heartbeat) was expected, but it was not too bad. Her oxygen saturation started to come to normal, after we had given oxygen.


All these things happened in 3 minutes time and the mother was now stable. Then we checked baby’s heart and I also did a quick ultrasound scan,  it was such a relief to see that the baby was having good cardiac activity (heart beat ) and was moving its limbs. We have a portable scan machine, which weighs only 2 kg and can be taken to any spot in emergency to do scan. It was then that I realised the full benefit of the machine,  when I could see that the baby was alive and kicking and there was no internal bleeding.


She was around 36 weeks  and started having painful contractions, so we could easily deliver her as the baby was mature. She had a Caesarian and a beautiful baby girl was delivered. Past history of Caesarian was an added indication. We managed to save both the mother and baby without any complications.

Only “FAST ACTION” saved the baby and the mother.
 
Even Small details are important during emergency situations and every single human being can contribute in such scenarios. An hospital should always be prepared for  emergencies and the following actions are very  important.
 
1. Training to staff  and trial runs - all staff should be included in the training, even the  cleaners and drivers.

2. Availability of emergency medicines and equipment, which are easily accessible and in good working condition.

3. Fast reflexes of doctors and staff, who should be not only well trained but also must be physically fit and well composed to deal with emergencies. Regular fitness and yoga helped me to reach the hospital on time.


I was very happy that we could save both the mother and child and I also realised that  training in the UK had helped me so much in preparing our hospital. If I had taken longer to dress ( Indian style dressing often takes time), if I could not run, if I went breathless, if I could not lift her, if I  did not have loud commanding voice to get people  do stuff, if I did not know what emergency injection to give, if injection was not available, we could have had a disaster. Even if hospitals have all the facilities, many times there is a delay of 10 minutes  or more, which often leads to complications and fatalities. Always being prepared for an emergency will avoid such unfortunate incidents.



Media is always talking about negligence of doctors and paramedics. But do they know what medical professionals endure all the time? Do they know that we leave our children and rush to save other kids? Do they know that we never eat our meal without getting interrupted? Do they know that we get up at night constantly when there are reduced foetal movements, just to reassure the expecting mothers? Do they know that we are drenched in  blood in an effort to stop bleeding during surgeries? I never thought about the infections I will contract, when I was  covered in blood during emergencies. Can everybody put in such dedication  and sacrifice? 

Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre
anitadane@gmail.com

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Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani, who specialises in surrogacy. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm  and surrogacy. Her proficiency is in genetic abnormalities and high risk pregnancies.




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