Sunday 30 August 2009

Natural selection?

So, as well as being the evening for declaring my love for Thembe, Thursday was also my first, second-on on-call. Let me explain. Every day one person is the 'on call', this means they hold the mobile phone which all the outlying clinics ring for advice and from 4.30pm until 7.30am they are called if anything requiring a doctor occurs. And remember this is a hospital that has 7 wards (Paeds, SCBU, maternity, male, female, TB and isolation) as well as being the local casualty. As one of the things that is often required overnight is a c-section, there is also a second on who gets called for those, and also for any major incidents. Actually, as we pretty much all live in, I think we'd all be called if there was a major incident. The person who is first on then works a half day the following day, finishing at 1.30pm. Oh yes, a 30 hour shift. Eat your little EWTD hearts out!
Anyway, shortly after my love decleration, my phone went off. The 32/40 PET lady with deep variable decels on her 10 minute CTG trace who we'd been planning on transferring to the nearest specialist centre, a mere 3 hours down the pot holed road, was now flatlining (for non-medics, a lady who was pretty sick with a premature baby had just got a whole lot worse). So we'd decided to section her.
I was to be the anaesthetist. And the paediatrician. Caring for two quite unwell patients at once. Scary biscuits. Not as scary however as when the baby came out looking pretty ropey, breathing a lot faster than is normal and grunting away (not good). I'm going through my usual resuscitation procedure. And then some. And I suggest to the surgeon that I attempt to intubate to give the baby some medicine directly to the lungs to help it's breathing (not something I've ever actually done before but I've seen it done and I'm learning that that's what counts). And he looks blankly at me. "Surfactant?". When I explain, he replies that we don't have that. So I suggest CPAP (breathing apparatus). We don't have that. I decide to just ask what we do have. Just oxygen. By nasal prongs. And a warm room. So that's what we do. Miraculously the next day, the baby is still alive and looking perky. The midwives assure me that "black babies are a lot tougher". And apparently it's true. They kind of have to be.
Interestingly enough, there is a plane that we can call for to take babies to the bigger centre. But it only flies between 8am and 3pm. On sunny days.
Fortunately that was it for my on call and I slept until morning. And then did a full day in clinic. Not looking forward to my first first-on on call on Tuesday.

3 comments:

  1. Your first on call will be fine. Hey, I was on call today. And spent hours arguing with a woman who wanted her venflon taking out cos it stings. I might transfer her, via the plane described above, to your place.... and one of yours can come and get some IV Abx, BiPAP and an epidural. We'll see how the natural selection works out then...
    x

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  2. Good luck tonight Caroline. & there I was thinking Emma's life in Wales was remote because they can't buy ice cream as it melts before they can get it the 1 hour car journey home...

    Han Q

    P.S. Oliver how to do you get your posts to title with your name?

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  3. Comment as 'Select Profile' bit - choose Name/URL and type in your name.

    O xx

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