‘Oxygen mask, oxygen cylinder, and a helpless Lady trying to keep her breath going’- where is the healthcare system?
May be the healthcare system is itself in the ICU.
Let’s tell you about a poor girl Minahil and then ask the question who killed poor Minahil ?
It was 2 pm when I was watching at my feet which were swollen after a long 30 hours duty. I picked up my bag and started walking towards the gate of the hospital when I saw some people come running to the Emergency carrying a 14 year old child who was almost soaked in blood. I knew by the look that it is Head Injury. I get back to the emergency with them again. I saw the other doctor was busy in resuscitation of another collapsed patient when I gave him the look “I got it”. I threw my bag on chair and shouted “Crash Trolley”. Child had aspirated the blood and was still bleeding from mouth with occasional gasps. I shouted for E.T.T but the right size wasn’t there at all. I asked my staff to run to ICU and bring one. I did blood suction from her airways how much I could and managed it initially. Now, our hospital didn’t have any Neurosurgeon. As patient wasn’t entitled for our hospital, I asked the M.S to provide us ambulance so that we could shift the patient to DHQ.
I was constantly providing her assisted breathing via ambu bag.
We examined her and asked for CT scan. Attendants went to Radiology Dept. & CT Scan machine was out of order. Now to get the CT scan she must be taken to a radiology center nearby which requires mobilization in this condition, which is completely against every standard protocol.
We needed Ventilator and oxygen but all 4 oxygen cylinders were occupied and had to bring from another ward and many times even that will not work, 17 minutes wasted were wasted just in this.
CT Scan was done from outside the hospital, another 21 minutes wasted.
There was blood in the brain and decompression had to be performed but Neurosurgeon resigned from the hospital because he was beaten by shoes by some attendants.
She was then referred to a bigger hospital, which took another 8 hours and nothing could be done in the meantime to improve her condition.
Total 9 hours and 45 minutes were wasted, the most crucial time to save a life in that condition!
I followed the case and the poor Minahil died because of sepsis even with strongest antibiotics cover after 4 days of ICU stay with severe brain damage.
Now let’s consider the scenario of care in a Private Hospital … !!!
In a well-known private hospital, I went to Casuality and started dealing with routine emergency. Suddenly I heard the cries and saw a patient coming on stretcher. By the look, I assumed it a head injury and yelled “Class 1 Emergency”. At the next very moment 2 nurses were there with me while clinical assistant was dragging emergency trolley full of all kind of resuscitation instruments and medicines. Another guy was on the intercom with fingers on the dialling pads.
Patient was bleeding from the ear and gasping with blood from the nose as well. I passed E.T.T and started resuscitating. I yelled, “Dr from ICU … “.
In next 2 minutes, ICU Doctor was on the floor, managing the patient with me.
I yelled “Neurosurgeon”. Precisely 1 minute later, he was standing on the patient.
I yelled “Radiology for CT Brain”. In next 15 minutes we were watching CT Scan.
Surgery was planned and started.
ICU people kept 1 bed ready for the patient.
I saw the Medicine notes and raised my eyebrow over the doses and antibiotics were very basic and the patient survived.
Today, I am thinking …
Who killed poor Minahil?
“I wish I could tell the poor family of Minahil that the health system took their child’s life. I wish I could show the image of that poor soul who still haunts me, for which I tried so hard but the system won and I & she lost. I wish, I could ask everyone to raise their voice against the system that take lives.
I wish, I could tell them it wasn’t me (the Doctor) who took her life, it was the system. I wish, I could tell them that I am raising my voice for every Minahil who can’t afford Private Hospitals and I could make them realize that there is so much wrong at so many levels in this system …
Factors like overload of Patients, free treatment, poverty are used to downplay the efficiency, and suddenly we start having the attitude that whatever poor Patients are getting is still enough for them, drastically ignoring that they can get much better if system is made accountable. There are resources, funds are given for those resouces but there is no accountability. Let's realise where the problem lies and then ask the right questions.
Dr Mayank Gupta
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