An #COVID19 patient in ICU will be sedated, paralysed and intubated.
The drugs used to facilitate this process of rapid sequence intubation need to be given in exact quantities.
If a doc isn't experienced at doing this,patient will definately die.
The drugs used to facilitate this process of rapid sequence intubation need to be given in exact quantities.
If a doc isn't experienced at doing this,patient will definately die.
Its very different intubating a sick patient in a ICU compared to a well patient just needing routine surgery.
You have a more narrow choice of drugs and the chances of it going wrong are way higher.
Wrong choice dose of drugs by doctor and the patient can die.
You have a more narrow choice of drugs and the chances of it going wrong are way higher.
Wrong choice dose of drugs by doctor and the patient can die.
If the intubation process becomes difficult, which is not uncommon, the doctor may need to cut the patients neck in a very specific way as a last resort.
A doctor that just did a 5 day masterclass and is inexperienced at this procedure is likely to make mistakes.
The patient can die during this process.
The patient can die during this process.
Once the patient is intubated and on a ventilator, settings need to be adjusted regularly. You may even need to ventilate patient in a prone position.
ARDS management is very complex. If mistakes are made here, patient can die.
ARDS management is very complex. If mistakes are made here, patient can die.
Monitoring also includes being able to understand how to interpret and take arterial blood gases which few Nigerian docs outside anaethesia know how to do.
Its commonplace in UK/Italy. Even every junior doctors take ABG's regularly.
Its commonplace in UK/Italy. Even every junior doctors take ABG's regularly.
Anyway if a doctor/nurse cant interpret correctly. Patient can die.
In addition to the ventilator, there will be complicated circulation drugs being pumped into the patient like noradrenaline. Sometimes even up to 3 pumps of these circulation and life support drugs.
Hardly any doctors in Nigeria outside the tiny number of anaethesia know anything abt using these drugs.
Few hospitals have the equipment. Whereas in developed countries they are commonplace.
Few hospitals have the equipment. Whereas in developed countries they are commonplace.
Anyway, if mistakes are made with these drugs in inexperienced hands.
The patient can die.
The patient can die.
Etco2 monitoring..how many doctors even in anaesthetics read etco2s on a regular basis. But this is important for ARDS patients.
Where are the Etco2 monitors? How many in Nigeria??
Where are the Etco2 monitors? How many in Nigeria??
If you are not measuring....patient can die.
An arterial line should be placed in such a patient to monitor BP invasively. How many doctors in Nigeria know how to do this? If we ignore this.....patients can die
What abt the CVP which should be placed under ultrasound guidance? Where is the ultrasound first of all? How many Nigerian docs place these on a regular basis??
Without sophisticated montioring. Patient can die
Intensive care isnt something you just jump into.
You need a 'core' speciality first..after years in a base speciality then you can start ICU training
ficm.ac.uk/trainingcurric…
You need a 'core' speciality first..after years in a base speciality then you can start ICU training
ficm.ac.uk/trainingcurric…
Nigeria doesn't even have a stand alone intensive care training pathway. Its something that most anaesthetists in conjunction with their day to day work in theatre.
If we get to the point Italy is at where they have thousands of patients needing critical care. Its game over for Africa..we have to focus on the basics
We don't have the money, manpower, equipment and resources for anything else.
God bless.
God bless.
