Day 17, I’ts just gone 11 at night and I’ve just come back from the OPD. I’m on call today and there has been a steady stream of patients, most of them minor injuries and I have spent the last 4 hours suturing patient after patient. I’m feeling a little sleepy but I have the South African Family Practice Manual open and am desperately trying to read up on general anaesthesia.
This is because I don’t expect to be sleeping through the rest of the night, there’s a primip on labour ward and she’s failing to progress, the baby is starting to get distressed and we’re probably going to have to do a caesarean section tonight. I’ve been prepared for this, I was aware that it might come to this and I even went to a couple of sections to see the spinals being given during the day time. It’s not a whole lot different to doing lumbar punctures and I think I’m fairly happy to have a go.
Slight hitch however. She’s spiked a fever and dropped her platelets, to the non medics out there this basically means that we can’t use a partial (regional) anaesthetic and if as expected we take her to the operating theatre, then I am going to have to administer a general anaesthetic and put her to sleep. This is the point where anyone in my position, never having ever even been close to administering a general, would start spewing a barrage of expletives.
Seeing as I’ve never used the anaesthetic machine before I’m hoping if it comes to it, then the surgeon on call is going to be able to whip this baby out before the ketamine wears off. The thought of how things could go wrong and I could end up having to intubate her and use a ventilator to support her breathing is pretty scary but at the same time exhilarating, like the climb up to the top of a rollercoaster, right before you get hurled in all directions.
Don’t know how this is going to play out, better carry on with the reading.
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