Sunday, April 27, 2008

Oh gosh!

(Warning : medical gobbledygook ahead)


I recently met a senior colleague of mine who is attached to the ETU (Emergency Treatment Unit, a.k.a. A&E) of a big hospital in Colombo. Little beads of sweat dotted my forehead as I listened to his experiences there. The trauma scenarios he described were horrifying, even though I have had a decent training at NHSL.

A few weeks ago, a youngish guy had been admitted following a road traffic accident (RTA)... a nasty collision with a train during the wee hours of the morning. While the rest of the body was ok, he had severe injuries to the head, including facial fractures that were a combination of Le Fort II and III. In other words, his facial bones were in 4 fragments... (shudder).

My friend and his team had been trying disparately to intubate the patient, as that was the only way to secure the airway and ensure he didn't aspirate from the torrential bleeding. Every time they tried to insert the ET tube, part of the face would move forward or backwards or sideways....making the task next to impossible.

That's when they decided on a radical approach, one I had never heard of before. They created an emergency tracheostomy and inserted the guide-wire of a CVP line upwards through the larynx and out of the mouth and then guided the ET tube down the wire!! I was open mouthed with admiration at whoever came up with this maneuver. Thanks to their quick action, they were able to get the patient stabilized on a ventilator.

I'm not sure what happened to the poor guy, but I hope he survived.

My applause goes to all innovative doctors out there.... for their clear headedness in the face of the seemingly impossible - a trait that saves lives.

15 comments:

Dili said...

Thats genius. Thats basically going the other way around isnt it? Neat job.

Lady divine said...

OMG!!!! hats off to the quick thinking and brilliant solution....
wow... I'm still freaked after reading your description... gosh!!

pissu perera said...

ok i'm going to sound like a real bimbette for submitting this kind of a comment to that type of post, but i spent 2 nights in the durdans etu (for lack of rooms) and saw 2 total hottie docs :D

yes, you can call me a superficial bimbette now

Meese said...

pretty cool, beats ER or Greys anatomy i would say :)

santhoshi said...

you have been tagged. check my blog spot

chaarmax said...

Just to say that you my dear have been Tagged. Now your It. So go spread some love. :)

~ lo$t $oul ~ said...

off topic..

didnt see your comments on the designs..

Bo said...

Wow hats off to those doctors. Now, this is some thing new to discuss with my groupies. Still have not done an intubation or tracheostomy on a live person. but have tried it so many times on dummies during anesthesiology cycle. thanks angel for these informative, yet creative blog posts. Enjoyed reading them.

sachithvida said...

From what I hear, our doctors are quite talented, they do an impossible job without much of the help from the administration.

I read about a rape victim survivor on the Reader's Digest some time back. She was severely beaten on the face. She was meant to drown in her own blood, but the criminals had partially cut off her throat...gross!!..As they later analyzed her survival, she survived because she could breath through the cut on her neck!!!...

I guess if you have enough good in you, you are pretty hard to kill..

About the MD exams, my sister went through the same around a year back, but she has a way of making exams seem so easy..:-P So I guess I didn't realize how hard they are...:lol:

Angel said...

Lo$t $oul: how do I access your blog? None of the links seem to work!

Bo : get as much practice as possible. Wow, good that you've done virtual tracheostomies too... we never had those...

Sachith : Interesting story... Kudos to your sister too, that takes real smarts.

~ lo$t $oul ~ said...

oops ma bad. forgot to leave the link..its:
brokensouline.blogspot.com

Anonymous said...

Do you have copy writer for so good articles? If so please give me contacts, because this really rocks! :)

Angel said...

Annon : um no. I write everything myself. Thanks for the compliment.

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