Day 20 of the Daily Lenten blog journey…
I almost didn’t finish yesterday’s post due to the events of todays post.
Yet another major emergency went down yesterday evening. I heard Dr. Isaac calling on the radio for one of the nurses. Then, shortly after, for a surgeon. I knew that he had previously gone down to do a C-section on a woman, so I was worried this likely meant something was not going right. Not only was he looking for a Surgeon’s help, but also for a Bakri Balloon (which is a balloon that can be inflated with water, inside the uterus, as a means to stop bleeding by way of pressure).
So, being the astute detective that I am, I ascertained that a postpartum patient was bleeding really bad. Since I knew where the balloons were, I sped down to see if I could help. I wasn’t the only one; several other personnel had arrived, as the situation was evolving from urgent to emergent.
Joanie (not her real name) was 39, and this was her 13th pregnancy. This was the first child she had delivered in a hospital. She had already lost 2 babies in the past at home, for unknown reasons. She had just delivered a son via C-section, after failing to deliver vaginally. The baby boy was very large by Honduran standards, at 10 pounds, 4 ounces. A combination of having had so many previous pregnancies, along with the recent delivery of a very large baby, put her at higher risk for the complication of Uterine Atony (where the uterus doesn’t clamp down to stop bleeding). Consequently, she just kept bleeding and bleeding, despite all the interventions our team was implementing.
Then, we got the call for the first Unit of blood. Her pulse was too fast, and her blood pressure was low, which are both ominous signs that she had lost too much blood. Here in the jungles of Honduras, it turns out that bags of blood don’t grow on trees. Papayas, yes. Mangos, yep. Blood, no. What we do have is plenty of warm bodies. We employ a strategy of whole blood transfusion at our hospital, which means that we have a walking blood bank. Anyone who has lived her for a substantial period of time has likely donated a unit of blood.
Luckily, we had a spare unit of her type of blood in the fridge. It would turn out to be a huge blessing to Joanie that she had the most common blood type here, O+. Consequently, there was a call for “at least 2 or 3 more units” of blood. Interestingly, the first unit of blood we drew was from one of our surgeons, who would go on to help perform surgery less than an hour later. Next up, was the patient’s husband. And third was me.
Things started becoming even more dire, and the surgical team decided to abandon plans to just stop the bleeding, and transition to taking her uterus out. It was the only way to stop the blood loss. Either remove it, or bleed to death.
At this point, the objective became: just keep drawing blood until we tell you to stop. We had to rally people to bring their veins down to the hospital so we could suck em’ dry.
As fast as we could draw them, they needed more. It was a race against time for the surgical team. They had to get her uterus out, while keeping her arteries flowing with the lifesaving red stuff.
Eventually, the fortunes of the battle turned in our favor. The surgical team was able to remove the uterus successfully, and her blood pressure and pulse stabilized. It was an amazing display of teamwork. The surgical staff, laboratory team, neonatal crew, and the blood donors all fought for the life of this woman and her baby, and the efforts were blessed with success. At the end of the day, we gave her 8 1/2 units of blood, which means we probably replaced her entire blood supply by the end.
Photo of the day:
Howler monkey mama, and her juvenile, In our back yard.
Hasta mañana, por numero 21
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