{"id":19,"date":"2011-02-17T15:15:43","date_gmt":"2011-02-17T15:15:43","guid":{"rendered":"https:\/\/inmedblogs.us\/asdiswagner\/?p=19"},"modified":"2015-06-05T15:24:21","modified_gmt":"2015-06-05T15:24:21","slug":"bmc-days-3-and-4","status":"publish","type":"post","link":"https:\/\/inmedblogs.us\/asdiswagner\/2011\/02\/17\/bmc-days-3-and-4\/","title":{"rendered":"BMC Days 3 And 4"},"content":{"rendered":"

\"bmc-peds-ward\"<\/a><\/p>\n

 <\/p>\n

The last few days are kind of a blur as a lot of things have happened. It has been incredibly hot here and although I am trying to drink several liters of water or gatorade each day, I am barely keeping up with the amount I am sweating.<\/p>\n

 <\/p>\n

Yesterday (Wed) had a rough start. I started to round with Dr. Prine, a pediatrician that is here, and we started in the Peds Ward. We had just finished examining a 6 mo old boy and we walked across the room to check on another baby when all of a sudden the mom says something and the nurse calls us back to the bedside. The child had died! No more than a minute after we had been there checking on him. He had been rushed to the OR the night before due to an acute abdomen and had been found to have severe intussusception. We thought he was on the road to recovery but things change pretty quickly here. Also, we don\u2019t do CPR here since there are no ventilators here and the staff is not trained. Death is pretty much an every day occurance here at the hospital, usually a few each day, but this was the first child we lost since I\u2019ve been here.<\/p>\n

 <\/p>\n

When we recovered from the shock we finished our rounds in the peds ward. We have a lot of malaria patients, typhoid with\u00a0or without GI perforations, meningitis,\u00a0TB, and malnutrition. I did my first lumbar puncture on a two year old\u00a0girl that\u00a0we\u00a0suspect may have meningitis.<\/p>\n

 <\/p>\n

Clinic on Wednesday was busy and I admitted four new patients to the hospital, and once again the hospital was overflowing as all the other docs admitted several patients as well. After clinic I checked up on some of my patients and then proceded to round again with Dr. Prine in the Peds ward. As we were finishing up, someone brought a tiny little girl to us. She was a twin that had just been born at home that day, and the mother had died due to some complications during the delivery. She is probably a little premature, about 35 weeks, and was struggling to breath. We were able to give her some oxygen and put her in an incubator but she needed constant stimulation and occasional ventilatory support to keep her oxygen level up. Sheila and I volunteered to stay overnight in the hospital to take care of her\u2026 and we were in for a crazy night!\u00a0Only in Nalerigu could all this happen at once!<\/p>\n

 <\/p>\n

The night started a few deliveries that the midwives handled, but the little girl kept us busy as we took turns bagging her every once in a while. Then we got a call about a woman whose labor was not progressing properly and we decided that she needed a C-section so we woke Rich up and he took care of that. Things calmed down for a while but then I was called to a patient\u2019s bedside and all I was told was that \u201cher condition has changed\u201d. When I got there the patient was\u00a0gasped a couple of times but\u00a0then died. Unfortunately there is nothing we can do in these situations when the meds don\u2019t work, since we don\u2019t have all the necessary\u00a0equipment.\u00a0I haven\u2019t had to pronounce someone dead before but\u00a0it was a 70 year old lady with severe pneumonia.\u00a0Sheila was up for the next call so I stayed with the baby girl. Again, all we are told that we needed to check on a patient in the women\u2019s ward\u00a0since \u201cher condition has changed\u201d. She gets there through the interpreter figures out that the lady is having contractions. As she\u00a0hears that, the lady gets up,\u00a0squats on the floor and delivers a baby girl!!\u00a0Everyone was just standing and watching her so Sheila came running back to the maternity ward where I was and grabbed what she needed to cut the cord, suction the baby, etc.,\u00a0but both mother and child\u00a0did well.<\/p>\n

 <\/p>\n

Our night wasn\u2019t over yet, and we did have to call Dr. Prine to come help us because we couldn\u2019t keep the little girl oxygenated well. Her O2 sats kept dropping, but he was able to stabilize her and she was fine for the rest of the night. However, the worst was yet to come. Around 6 in the morning I took the next call and I was told that a woman was being brought to the hospital due to prolonged labor. We went outside and a few men were moving a young woman from a van to a stretcher so that she can be moved inside. She was obviously in pain but she had all these sheets and plastic wrapped around her waist so I couldn\u2019t really see what was going on as far as the delivery went. We took her inside to look her over and unfortunately I don\u2019t think I will ever be able to forget this sight! The baby had been delivered\u00a0breech (feet or butt first), she was unable to complete the delivery and the baby was stuck.\u00a0The\u00a0baby had\u00a0been that way for several hours was dead.\u00a0I called\u00a0Rich\u00a0in since neither\u00a0I, Sheila\u00a0or the midwives were able to get it out. The poor\u00a0woman was in so much pain but luckily\u00a0Rich\u00a0was able to help us and\u00a0the woman was actually doing really well today.<\/p>\n

 <\/p>\n

Dr. Prine came that morning\u00a0to take over watching the baby girl and Sheila and I decided that after a night like that we\u00a0needed to rest for a little bit so we\u00a0slept until\u00a0about 1pm. Luckily the afternoon and this evening were pretty uneventful\u2026 Admitted a crazy lady, Sheila did some sutures on a guy that fell of his motorcycle and we rounded on our patients. Dr. Prine and his wife were able to rig the equipment that we have so that be little girl is getting constant oxygen and CPAP\u00a0and they taught the maternity nurses how to check on her and make sure she\u2019s ok. We are not sure what\u2019s going to happen to her, but if she had been born anywhere else she would have had about 95% chance of survival but she needs to be on a ventilator, which we don\u2019t have. It is frustrating that we don\u2019t have all the equipment, technology, or trained staff to treat patients properly.\u00a0Well, my sleep schedule is all off since my call night so I need to try to get to bed before too long. Hope all is well with everyone back in Iceland and US!<\/p>\n","protected":false},"excerpt":{"rendered":"

  The last few days are kind of a blur as a lot of things have happened. It has been […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[1],"tags":[],"class_list":["post-19","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/inmedblogs.us\/asdiswagner\/wp-json\/wp\/v2\/posts\/19","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/inmedblogs.us\/asdiswagner\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/inmedblogs.us\/asdiswagner\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/inmedblogs.us\/asdiswagner\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/inmedblogs.us\/asdiswagner\/wp-json\/wp\/v2\/comments?post=19"}],"version-history":[{"count":0,"href":"https:\/\/inmedblogs.us\/asdiswagner\/wp-json\/wp\/v2\/posts\/19\/revisions"}],"wp:attachment":[{"href":"https:\/\/inmedblogs.us\/asdiswagner\/wp-json\/wp\/v2\/media?parent=19"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/inmedblogs.us\/asdiswagner\/wp-json\/wp\/v2\/categories?post=19"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/inmedblogs.us\/asdiswagner\/wp-json\/wp\/v2\/tags?post=19"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}