Aira Hospital

Internet has been down for almost two weeks – that’s why the blog has been silent. Only today I managed to connect.

In the western world you never see full blown ecamplasia with sky-high blood pressure, deep unconsciousness and seizures. Here it is not that uncommon. We do not have any sophisticated ways of treating that serious life threatening condition, but most our patients survives and recover although.

For controlling the high blood pressure we use Aldomet and Captopril. For the seizures MgSo4 solution by i.m. injection is an excellent drug, cheap and efficient. As a medical student in Denmark I was assigned to administer MgSo4 to eclamptic women, but now that treatment is obsolete and forgotten. When we asked a visiting surgeon from Sweden to bring MgSo4 to treat our eclamptic patients she brought the drug as oral preparation – a powerful laxans! We also use Valium infusion and i.v. injections.

The most important thing however is to deliver the eclamptic woman as soon and atraumatic as possible. If the child is alive and at full term that means a Cesarean in general anesthesia. Usually the seizures stop as soon as the woman has delivered.  But this patient continued having severe seizures even after being delivered by Cesarean.

VIDEO ← click here to watch video clip

After three days she has recovered. As always the child is lying somewhere in the bed.

VIDEO ← click here to watch video clip 

After two more days the lady is going home with her husband and newborn baby

We have instructed the couple carefully that it is of outmost importance that she attends our antenatal clinic for thorough follow up and prophylactic (preventive) treatment at next pregnancy.

Another clear example of the preventive health care the hospital delivers but do not get any recognition or reward for.

Actually we do not celebrate neither Christmas, nor New Year at this time. Christmas will be on January 7^th and New Year is on September 11^th. However we follow the same calendar as in Europe when it comes to registration of the operating room activities. I guess by old habit from the time when the hospital was a true missionary hospital run by the “foreignjies” (the white people).

3 786 is the number of surgical procedures performed in 2008, not including the several hundreds of eye surgeries done by the ophthalmic nurse at the OPD.

This remarcable result could never have possible without the hard working and dedicated operating theater staff who are always in full activity, never wasting a minute. Often they do two assignements at one time, like supervising the postoperativer patients and at the same time preparing surgical instruments.

The OR technicaians who have no formal medical training are doing a lot of minor surgeries on their own, and always closing up after major surgeries to speed up the program.

Maternity has also been busy. Often the staff there is overwhelmedd with complicated deliveres arriving simultaneously while at the same time they have to care for critical patients as well.

This lady came with IUFD (Intra Uterine Fetal Death – the baby had died in the womb) and very severe eclampsia. At arrival she was deeply unconscious with convulsions and very high blod pressure. The child was extracted immediately on arrival by craniotomy (destructive delivery). The patient had valium infusion, magnesium sulfate and hydralazine. The later had to be given at 5 minutes interval under continously controle of the blood pressure.

The nurse, who is doing her first clinical year and do not have a lot of experience wrote “Oh, God help us. Please!” And He did. The patients has recovered miracoulsly and is now semi awake after 48 hours.

eclampsia ← click here to watch a remarkable recovery from severe eclampsia in 48 hrs