‘Wu, go to the Emergency Department STAT!’
-that was Dr Thurstan shouting over the phone.
27 year old, female lady, referred for lower abdominal pain.
BP 80/50
Pulse 130bpm, tachycardic.
She was pale, as white as a ghost, cold clammy hands.
Abdomen distended, tender, guarding.
Was referred from clinic TRO Acute appendicitis.
Further history revealed POA 10 weeks. Recent sexual activity.
UPT POSITIVE.
Scan stat: Uterus empty, fluid in POD.
DIAGNOSIS :
RUPTURED ECTOPIC TUBAL PREGNANCY
She was in hypovolumic SHOCK!!!
Or basically bleeding away.
She was dying.
We were losing her.
1 pint Packed Cells- emergency ‘O’ in transfusion.
Bloods sent for FBC, GXM 6 pints, coagulation profile.
S/B Dr Raj.
Within 5 minutes, the specialist and OT (Operating Theather) were informed, consent taken, and the patient was pushed to OT for a Laparotomy Salphingectomy.
(simply means cutting her open and removing her fallopion tube)
Dr Nadiya was running for bloods.
Surprisingly, that’s how efficient our Government Hospital can be in times of dire emergency at 8.00pm.
I was assisting Dr Raj at the Operation Theather.
INTRAOPERATIVELY:
Hemoperitoneum noted.
Blood was oozing from her peritoneal cavity.
Left ruptured tubal pregnancy was seen.
Left salphingectomy done.
Right ovary and tube normal
Estimated blood loss : 3.0 Liters
Hemostasis secured.
Food for thought:
This is one of those amazing days which reminds me the beauty of being a doctor despite the tiredness and stresses.
A normal lady have approximately 5 liters of blood.
And this lady, she was losing 3 liters, which was 60% of her body blood.
And was indeed still bleeding.
And something need to be done FAST.
The adrenaline rush.
In the end, Dr Raj and the team saved this young lady’s life.
I was doing post-operative rounds and reviewed the patient later.
Her vital signs stable, Blood transfusion on-going.
She was with her mother.
I explained the operative findings and future plans.
She managed a smile and said 'thanks'
And that, well, that is something that money or anything in the world can’t buy.
To all house officers, medical officers, specialist, staff nurses, PPK, hospital staffs,
Sometimes, life can be tiring, exhausting, with the heavy workload,
sleepless nights, empty stomachs, terrible stress, ache-ing feets.
Perhaps, we need to remind ourselves from time to time,
to be strong,
to hold on........
the people need us.....
friends, relatives, friends of friends...
we are one big family....
well, i did not had time for dinner until 12 midnight,
i had a hectic on-call,
but i guess, sometimes, it's still all worthwhile...
Together,
making a difference.......