Saturday, June 1, 2013

Non WoW: Why doctors are useless for medical emergencies outside work

Yesterday morning I had a bit of a shock!

I was getting ready for work, hubby was in the bathroom, and his phone goes off.  I checked it, it was my brother-in-law, he'd rang twice.  I rang him back, no answer.  Weird.  Jokingly I said "Maybe they're having a baby now!"

My sister-in-law was due last Monday but if they baby hadn't come by today, they were going into hospital to get induced.  My sister-in-law and I had worked out what was happening with my nephew who goes to school with my daughter, and the plan was that he stay with us.

So I got into my car and my sister-in-law calls me, hangs up.  I call her back, no reply.  I only drive another 50m down the road and hubby calls.  "They just had a baby at home, on the floor!  There's no ambulance or anything, can you go over?"

"OMG!" I said, and did an about turn, and headed to their house.  I rang work to tell them I would be a bit late, and rushed to their house.

Fortunately, everything had gone well, but it was a bit of a shock.  She had woken up with some pain, and told my brother-in-law that they were 5 minutes apart.  He didn't know you could call 000 from your mobile phone (that's our emergency dial number in Australia) and so he went downstairs to make the phone call.  My sis-in-law yelled out "The baby's coming!  The baby's coming out!"  and my brother-in-law thought "Yeah right, not that quick," but a minute later he heard a baby crying.  He told me he was a bit stunned - he wanted to go up and see the baby but he was on the phone to the ambulance!  He wished that he had helped  deliver his own son.

By the time I arrived the paramedics had arrived and they had packed her up in a stretcher.  I took my new nephew from my sister-in-law and did a quick check and he seemed fine - good tone, good colour, breathing was a bit grunty but no sucking in of the chest, and his heart beat was good.  I hugged my sister-in-law telling her how clever she was and quickly went to put on my shoes and ran out with the baby in my arms to give it back to her in the ambulance (I went out the side door, they took her out the back door).  I took a photo of her and the baby and of us and the baby and then I was all grins and smiles as I drove to work as I relayed the exciting story of my nephew's entry into the world to all my workmates.

My sister-in-law told me that it was so quick - she woke up, and had the contractions were close together, she went to the toilet, her waters broke and then she felt like she needed to push and 1 or 2 contractions later, she had a baby.  All up - 7 contractions.  She couldn't believe it. And she said it was about 10-15 minutes from pain to baby.  So quick she couldn't even get in the car to get to hospital.

Even as a doctor, there really isn't anything I can do when I turn up to something like this.  I need my tools, my equipment - what do you have in the field?  Basic first aid and knowledge of basic midwifery is all I have at my disposal (even if I know advanced life support and have some idea of how to identify difficulties or complications in labour - what good are they here when I can't do anything!).

There have only been two times I have been required to do medical things outside of work.  One was on a plane and they asked for a doctor.  Someone was vomitting with a severe migraine and the customer service manager brought out their medical kit and I gave the passenger an injection of a medication to stop the vomitting so she could then take the 3 aspirin - after that the patient was better and had a sleep.  I went back to my seat.  As thanks, they asked me to select a perfume from the duty free catalogue.  That was nice.

These days, being a doctor on a plane is NOTHING like what happened to me then.  They ask for your assistance, you volunteer help and then you are taken to the passenger and you're actually not allowed to do anything unless you speak to the ground doctor and relay what symptoms you see and then you suggest your treatment and they have to OK it.  Friends of mine say it's like an interrogation, and you feel like they're accusing you rather than letting you do your job.  Another story I heard from a friend is that after fixing the patient, they were forced to sit with the patient for the next 5 hours on an overnight flight and were checked on every hour by the flight attendants, even though they told the stewardesses that the patient was then fine to rest.  So my poor colleague was exhausted by the time they got to their destination, without even the offer of a coffee or beverage.  However, other people have told me about upgrades into business class after assisting those in need on a plane, but those stories had all been from stories about 10 years ago.

The other time I attended an emergency, was when I was driving to work, and the car behind me took the offramp too fast, and it was an SUV and out of the corner of my eye I saw it speeding onto the onramp, taking the turn too fast and then if flipped for about 25m over and over until it crashed into the brick wall of the bridge, on it's side.  It was like watching something out of a movie.  I pulled over under the bridge and looked frantically for my hazard lights.  I found them and ran out of my car and I got beeped by angry drivers for stopping on a major road.

Look at the accident there morons! I felt like yelling.

I called 000 but I realised I couldn't do anything anyway.  Though I have training in Emergency Management of Severe Trauma and I work in one of the busiest trauma hospitals of the state, I was standing there, waiting for help to arrive.  I couldn't get the guy out of the car - he could be dying in there, but the car was lying on its side and there was no way I was going to climb up there to get him out - I wouldn't be strong enough to get him out, and I might even cause more injuries!  But more help arrived as more cars stopped, and some guys ran up and climbed the car, opened the door and helped a shaky looking driver out and he jumped down from the car, helped by the others (they JUMPED off and I was thinking OMG I hope the car doesn't topple back and squash one of them!).  He looked dazed and shaken and his face was covered in blood and cuts, so I just asked him to lie down while I just quickly asked him a few questions and checked for other injuries.  He seemed very fortunate, there was nothing else wrong.  The ambulance arrived and the police and then I had to answer a lot of questions and they packed the guy up and took him to hospital.  But what did I do?  Nothing!  I called 000!  Fat lot of good being a doctor that was!

So sometimes being at a medical emergency in the outside world and being a doctor, makes you feel even more powerless than someone who has no medical training at all.  And it's a weird feeling.  Luckily for me though, all my incidents had happy endings.  The scary part would be that one emergency where it was a dying or a dead person because THEN I would probably have to put some of my skills to use.

13 comments:

  1. Oh Navi! Those second babies....dang! My "patients" sometimes break my heart because there is sometimes nothing I can do for them except to remind them I love them and I am here for them. Maybe that's the best medicine of all.

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    1. See, at least you can do that. And perhaps that is just the right medicine that they need.

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  2. My grandmother was a stewardess back in the 1930s, when being an RN was a requirement. As far as I know, though, she never had to deal with any medical emergencies during the flights. Probably happened a lot less often, what with only 14 passengers on a DC-2.

    As an ICU nurse, Julie's been called on to deal with health crises outside of work on various occasions, some of them extremely serious. Like you, she's found that there's not a whole lot she can do without the proper equipment beyond calling for an ambulance.

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    1. I would imagine Julie had heaps of calls - I find nurses find more emergencies than doctors outside! Fingers crossed I have never had any major problems, though I guess at least if there was something major at least someone could help, so maybe I'm not so useless after all.

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  3. I'm still amazed by your sis-in-law after you telling me about it yesterday. Don't think that you did nothing for the car accident. Calling 000 is still something and imagine if his injuries were a lot worse. It might well have been the difference btwn life and death (even if you were waiting for an ambulance) but he did sound very lucky in this case.

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    1. Outside of the hospital, the only thing I've had to do is just an injection. :)

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    2. Hey, it's not JUST an injection! :D Normal people are scared to give themselves injections so just as well you were there to do it :)

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  4. Well you called 000 which is more than I could do since I don't have a cell phone. Congratulations to your sister-in-law, that's amazing!

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    1. I was very impressed with her! She felt stupid but I told her it was nothing of the sort!

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  5. Such an amazing story!

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  6. Grats on your new nephew :) Glad everyone is okay too.

    I think you're wrong though and that there is stuff you can do. First just having a doctor at the scene could be quite calming for the injured and the bystanders, meh you can always bluff them! Second, there might not be much you can do, but there's also a lot you can stop other people from doing. Another is the confidence in your own skills in even basic first aid, for example, how many other people get tested annually on CPR for example, the last time I did any was probably a decade ago! Some people never have.

    Last one, you could always Macgyver up an IV from some tubing, a couple of coconuts and a sharpened metal tube (I saw Jackie Chan do it in "Who am I" LOL) if you need to..... ;)

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  7. Awesome stories. I think a quick birth sounds much more appealing than long labours but that's a little too quick for my liking! My mum had my sister (her first child) in a caravan with the help of my dad (who was drunk at the time having just got home from darts).

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  8. Grats on your new nephew

    Everyone (paramedics included) are pretty useless without proper equipment. There is little you could do although probably not much needed to be done (or at least can be done in that setting). I doubt that the paramedics did much apart from checking vitals (which you would have assessed) and then stretchered her off routinely.

    and lastly...

    "It is on the wrong side of the diaphragm" haha I can say that you cant

    KSret

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I hope these comments work! Not sure why people can't comment lately, it makes me sad :(