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- Sep 19, 2018
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Hi SDN Anesthesiologists,
Brining to you my last 24 hrs unique cases (never happened before and that is why writing it - I was thinking of full moon myth, but apparently it is waxing crescent lol) in this district semi urban maternity hospital south east of Iraq, and I am still in the OR, just finished my last C-Section.
Yesterday morning at 0730 AM, we started with
2 cases (1 and 2) with one Primi failure to progress and the other previous 2 scars. Both were GA for C-Section and one had male baby at 0815 am and other female at 0835 am (these were post call cases - of Tuesday)
Then started new day :
Case #3- Ectopic pregnancy case - ovarian ectopic, 2 miss periods.
GA done... OK and no blood transfusion needed
Cases #4 and #5 (stich sinus removal and wart removal - mute patient)
Case #6- C-section done for Previous 3 scars under spinal anesthesia for her C-Section - moderate bronchitis. (male baby at 1220 pm)
Well... went for rest around 0130 pm
Got a nice sleep to start my night shift that I always run it with one anesthesia tech assistant !!!
At 0830 pm got a call for case #7 - from the labor ward with episiotomy uncontrolled bleeding.
GA given, 1 unit blood and 2 FFP - almost 2 hours operation time!
Had some rest like an hour, then got a call for a previous 2 scars with contraction - case #8, but the patient with 3 days rash eruption of chickenpox all over the body including her back, that I was concerned to give spinal anesthesia, but dared to give GA under cautions for the C-Section (male baby at 1220 am), and the most unfortunate that she had ruptured uterus, required blood transfusion and a general surgeon call, everything then OK and we were almost happy for the end; I was so upset about chickenpox and the way we deal with infection control !
I went to rest at 0230 am and got a call for another 2 patients
Case #8 with obstructed labor and required immediate delivery for deceleration and fetal bradycardia - the boy needed some resuscitation (caput presentation) after the C-Section under general anesthesia (male baby at 0400 am), even mother had cervical internal tear required repair too.
Case #9, an emergency patient with G6PD deficiency, her Hb was 6.7 and required blood transfusion of 1 unit on the table while finishing case #8, and C-Section then done under GA (male baby - 0445 am) , I got some delay recovery and advised for another unit of blood transfusion.
I then went to sleep at 0600 am and the same OB Attending called me about obstructed labor case - #10 and done under GA (male baby 0835 am).
Then we are now Thursday (full staff), and I gave 5 different cases out of 8 (called my colleague to relieve me, because I have an exam for special course CME credits for salary bonuses enhancement).
5 cases = 2 C-Sections - one Spinal (Hypertensive), and the other GA - (one female baby 0910 am and other male baby at 1200 pm); 1 D&C, 2 cerclage.
Not to mention 8 cases on Tuesday itself (8 C-Section and one of them Intrauterine death unfortunately) - 6 males and 2 female babies.
Still have the whole Thursday, now is 0115 pm.
27 cases till now...
I am tired...
Cheers and Peace from where I am !
Amir
Brining to you my last 24 hrs unique cases (never happened before and that is why writing it - I was thinking of full moon myth, but apparently it is waxing crescent lol) in this district semi urban maternity hospital south east of Iraq, and I am still in the OR, just finished my last C-Section.
Yesterday morning at 0730 AM, we started with
2 cases (1 and 2) with one Primi failure to progress and the other previous 2 scars. Both were GA for C-Section and one had male baby at 0815 am and other female at 0835 am (these were post call cases - of Tuesday)
Then started new day :
Case #3- Ectopic pregnancy case - ovarian ectopic, 2 miss periods.
GA done... OK and no blood transfusion needed
Cases #4 and #5 (stich sinus removal and wart removal - mute patient)
Case #6- C-section done for Previous 3 scars under spinal anesthesia for her C-Section - moderate bronchitis. (male baby at 1220 pm)
Well... went for rest around 0130 pm
Got a nice sleep to start my night shift that I always run it with one anesthesia tech assistant !!!
At 0830 pm got a call for case #7 - from the labor ward with episiotomy uncontrolled bleeding.
GA given, 1 unit blood and 2 FFP - almost 2 hours operation time!
Had some rest like an hour, then got a call for a previous 2 scars with contraction - case #8, but the patient with 3 days rash eruption of chickenpox all over the body including her back, that I was concerned to give spinal anesthesia, but dared to give GA under cautions for the C-Section (male baby at 1220 am), and the most unfortunate that she had ruptured uterus, required blood transfusion and a general surgeon call, everything then OK and we were almost happy for the end; I was so upset about chickenpox and the way we deal with infection control !
I went to rest at 0230 am and got a call for another 2 patients
Case #8 with obstructed labor and required immediate delivery for deceleration and fetal bradycardia - the boy needed some resuscitation (caput presentation) after the C-Section under general anesthesia (male baby at 0400 am), even mother had cervical internal tear required repair too.
Case #9, an emergency patient with G6PD deficiency, her Hb was 6.7 and required blood transfusion of 1 unit on the table while finishing case #8, and C-Section then done under GA (male baby - 0445 am) , I got some delay recovery and advised for another unit of blood transfusion.
I then went to sleep at 0600 am and the same OB Attending called me about obstructed labor case - #10 and done under GA (male baby 0835 am).
Then we are now Thursday (full staff), and I gave 5 different cases out of 8 (called my colleague to relieve me, because I have an exam for special course CME credits for salary bonuses enhancement).
5 cases = 2 C-Sections - one Spinal (Hypertensive), and the other GA - (one female baby 0910 am and other male baby at 1200 pm); 1 D&C, 2 cerclage.
Not to mention 8 cases on Tuesday itself (8 C-Section and one of them Intrauterine death unfortunately) - 6 males and 2 female babies.
Still have the whole Thursday, now is 0115 pm.
27 cases till now...
I am tired...
Cheers and Peace from where I am !
Amir
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