Delhi gangrape case; Aerial transfer of a critically ill and haemodyanamically unstable patient could be a less intelligent decision: The Human Rescue Team

Aerial transfer of a critically ill and haemodyanamically unstable patient could be a less intelligent decision if the potential life saving facilities are locally available. In fact it may put the patient at definite risk. It may disturb effectively the haemodyanamics & electric regulation of the heart as patient’s autonomic nervous regulation must be already challenged due critical disease process and mayn’t respect well an altitudinal insult: The Human Rescue Team

(Check a science report pertaining to the issue in the attachment (Urgent air–medical transport: Right patient, place and time; 181.569.pdf)

Disclaimer: Its’ a knowledge based information only and no authoritative value is claimed with it


High drama at 30,000ft as girl’s blood pressure dips alarmingly

By Kounteya Sinha, TNN | Dec 28, 2012, 01.24 AM IST

Delhi gang rape victim remains 'extremely' critical: Singapore hospital

Delhi gang rape victim remains ‘extremely’ critical: Singapore hospital

NEW DELHI: There was nerve-wracking drama at 30,000 feet when Nirbhaya, the 23-year-old Delhi gang rape survivor, went into a near collapse in the air ambulance on the night of Wednesday-Thursday as she was being ferried on a six-hour flight to Singapore’s Mount Elizabeth hospital.

Nirbhaya’s blood pressure suddenly dipped alarmingly, and in what is being considered a medical feat, critical care specialists Dr P K Verma of Safdarjung hospital and Yatin Mehta from Medanta Medicity created an arterial line to stabilize her. An arterial line is a thin catheter inserted into an artery – used mainly in intensive care – to monitor blood pressure real-time, rather than by intermittent measurements.

Explaining the mid-air crisis to TOI, Dr M C Mishra, chief of AIIMS’ trauma centre said, “We had explained to the girl’s family the potential risks of transporting her to Singapore. She could suffer a cardiac arrest or her blood pressure could fall alarmingly. After discussions, we took a calculated risk by creating an arterial line.”

Dr Mishra added: “Monitoring blood pressure from the arms can sometimes give false readings up to 20 mm which could be critical in such a delicate case. Dr Verma is well versed with hemodynamics (study of blood flow) and is very well aware of Nirbhaya’s condition while Dr Mehta is highly experienced. They did a great job.”

Nirbhaya was wheeled into Mount Elizabeth hospital at 9.10am (Singapore time). She underwent a full CT scan and was taken to the intensive care unit. Dr Mishra informed that the doctors in Singapore have told him that Nirbhaya’s blood pressure is now under control and her condition although critical, was stable. Despite all the complications, her fighting spirit remains unbowed and she is bravely battling on.

Dr Kelvin Loh, Mount Elizabeth Hospital CEO, was less reassuring. He said in a medical bulletin at 7pm on Thursday that Nirbhaya’s condition “remains extremely critical”. “Before she was admitted to our hospital she had undergone three abdominal surgeries and had a experienced cardiac arrest in India. A multidisciplinary team of doctors is taking care of her and taking all possible steps to stabilise her condition,” he added.

The team of Indian doctors that reached Singapore on Thursday morning also informed that Nirbhaya’s ejection fraction (EF) – an important measurement in determining how well your heart is pumping out blood and in diagnosing and tracking heart failure – has dropped to 25%. Normal EF is around 70%.

“When Nirbhaya left yesterday for Singapore, her EF count was around 50%. On reaching Singapore, her EF dropped to almost 25% which means her heart condition has been deteriorating. A normal heart’s ejection fraction is around 70%,” a source in Safdarjung hospital told TOI.

Doctors also fear serious neurological damage to Nirbhaya’s brain as doctors could not find her pulse and blood pressure for nearly three minutes on Wednesday when she suffered a cardiac arrest.

“Doctors in Singapore conducted a full body CT scan on Thursday. They are also looking at any neurological damage that could have resulted from the cardiac arrest. She is under heavy sedatives,” doctors at Safdarjung hospital said.



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