Saturday, December 5, 2009

The Labor Room

O&G was not like the other postings.
There were more emergencies. More excitement.

It's because in the other 2 postings that I went through, Paeds and Ortho, all cases are screened in the A&E before they come to the ward. If the patient is unstable, they are stabilized before being sent to the ward.

In O&G, the labor room is our A&E. All pregnant ladies are sent there (very few are sent to the A&E). So, you see and play a part in managing emergencies in the labor room.

It's not to say that you see an emergency very often, but you see it enough.

There are some stories that I would like to share..these are the things I saw, my experiences. They are better stories, but then I wasn't part of it, so can't really tell those stories properly, so most probably won't be telling them.
(I will try my best to tell it as simple as possible, but am not going to explain everything (cos then it would take very long), so if you are curious enough, please google for it)
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My MO was doing a Caesarean Section (LSCS) in the OT. Our specialist(S) was doing rounds in the labor room. S received a call and was on the phone, so I decided to go to the VE room (where we clerk patients before deciding whether to admit them to the labor room or to the ward or to discharge them) to see if there were any patients to clerk.

One lady was there, doing CTG (cardiotocography - to see the fetal heart activity). It was her 5th pregnancy, and she had already delivered 4 children via SVD (vaginal delivery). She came due to contraction pain.

I asked her all the questions I needed to ask, and then left her to finish the CTG (which takes about 20 minutes) and started writing down the clerking. She came after completing her CTG and looked quite uncomfortable, so I decided to do a VE first before proceeding with the clerking.

I did all the necessary examination and then did the VE (vaginal examination). I was shocked!! I felt a feet, and I could feel the whole feet. I panicked, and told my friend to call the MO.

I waited for my friend for what I felt like eternity. Then, I decided that I can't wait any longer. I told the lady to just lie down and not push and ran into the labor suite myself. Then I was told that there were no MOs around, only the S.

I went straight to the S, and told, Dr. L, there is a patient in the VE room, feet presentation. The S immediately came with me and attended to the patient. Confirming the presentation, she said prepare for LSCS (which mean you have to take her blood, set line, get the op consent and blood consent and send the booking slip).

But we only have one MOT. Dr. L decided that she would go into the OT to finish up the op that was going on so that this lady can be pushed in faster, before this baby decides to come out. At the same time, there was another emergency inside the labor room, a fetal distress. That makes it 2 LSCS waiting with one OT occupied.

The solution - fetal distress was sent to GOT (an ambulance will bring the patient to the main building for that) and feet presentation will go in after either of the LSCS (whether in MOT or GOT) is done.
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I didn't expect 1 story to be that long!
Although now, I feel it's not as exciting as when it was happening.
Will try a different story tomorrow.
Hopefully that will sound better once written down.
Good night!

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