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Published: August 3rd 2011
Today I almost had a heart attack a few times. The first was on morning rounds in the hospital when they said that a baby had a bilirubin of 430! (for those of you who are nonmedical we generally start to get concerned around 15) Then I realized that they use mmol/L instead of mg/dl. So this is still actually high enough to require exchange transfusion (which they unfortunately did in the evening after we left so I didn't get to participate) but not nearly as high as I thought.
Then this afternoon in clinic they brought in a 10 day old baby from a very rural region who was seizing and it didn't stop with medicines. The baby had been born at home with no pre or postnatal care and both the baby and Mom were unimmunized. They decided that the baby needed to go to the ICU (which only has 10 beds for all the adults and children in the hospital). The baby needed to be intubated so we went with the medical officer (MO) and then Dr. Brown met us there. At first we couldn't intubate because the baby was seizing and biting on the blade and
tube. When we paralyzed the baby the MO tried to intubate twice and was unsuccessful so then Katie and I each took a shot and were unsuccessful (by this time the baby had a lot of blood in his mouth) While we were trying the get an airway the baby became bradycardic and we had to do compressions. I can't even tell you how much we were missing our PICU nurses during this!! There is no such thing as a code cart and there were no nurses at bedside (in the ICU!) so I had to run out of the room and ask the nurses to get epi and other meds and then we had to draw up the meds and flushes ourselves. Luckily we didn't have to use the meds because Dr. Brown was successful with his intubation and then the baby's sats and heart rate normalized. So basically we are PICU attendings now. This baby had a very rare diagnosis but we don't want to spoil the super sweet morning report we have planned so if you want to know the answer you will just have to attend.
Needless to say we were very happy that Pam had
a couple of Windhoek lagers waiting for us when we got home this evening 😊
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JC
non-member comment
WOW!
so, i'm here... waiting for the update on the baby... i feel like i'm watching and internet soap opera!