Lydia had been admitted for 2 days in
another private hospital because of weakness of the body and feeling to faint.
The other facility attributed the symptoms
to malaria and they prescribed for her oral malarial treatment.
The patient was
also found to be anemic, and the condition was related to the hemolysis caused
by malaria. Therefore she was also prescribed hematinics and she was discharged
with the indication of doing an abdominal ultrasound as outpatient and of taking
back the report to that hospital later.
In the discharge paper there was no reason
given for the prescribed sonography and the only diagnosis written was “anaemia
secondary to malaria”.
The patient was referred to a private
doctor for the ultrasound and she was verbally told not to come to Chaaria for
the same, “because our ultrasounds are substandard”.
I felt very bad when the patient told me
like that because it was not the first time and I find very unprofessional when
a colleague is sending such unjust and fake messages about our hospital: I have
been doing ultrasounds for the last 20 years!
Nevertheless, I decided to forget the pain
and to perform the requested examination.
Actually the ultrasound was extremely clear
and useful: in spite of somebody calling our tests substandard, we were
immediately able to diagnose a ruptured ectopic pregnancy with a lot of blood
in the abdominal cavity.
We repeated an urgent full hemogram and we
found that the patient had lost 2 grams of HB from the morning, when she had
been discharged from the other hospital, up to 6.30 pm when we had received her
in outpatients’ department.
Now she had an HB of 4 grams/dl, and we had
to organize for urgent grouping and cross matching.
The staff of the theater has been wonderful
as usual, and we were able to start the operation in 20 minutes’ time.
The procedure was successful, although we
were literally flooded by the enormous amount of blood collected in the
peritoneal cavity.
The blood in our bank was fortunately enough:
we transfused the patient in theater first, and then overnight.
The following day Lydia was well and able
to sit in bed. The malaria slide was absolutely negative.
It is my opinion that in the other facility
there was a misdiagnosis and that the weakness of the body, the fainting and
the anemia were not at all related to any malaria, but rather to an ectopic
pregnancy which had been missed by the other clinicians.
On the other end, in spite of being a
substandard hospital, as some colleagues are assuming, we were able to make the
correct diagnosis on the spot, and to save the life of the patient with a
timely operation.
Bro Beppe Gaido
2 commenti:
"At times it's very discouraging when one is doing their level best and all you receive is negativity. There will always be such people never mind them because there is another 99% who really do appreciate the effort the entire team make and would be lost without that help. There is Swahili saying that says, tenda wema nenda zako. When i face criticism and I know am doing my level best, I always remember that saying. At least this case endend on a positive note)" Caroline
"doc doc. u have been in this game for long. the best way to prove to them that it is true their talk is to do better and better than them. this is affirmation by denial. good work so far." Paul
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