Life
Wins at Wockhardt Hospital, Mira Road: Experienced clinical acumen and medical
team work saves a critically ill injured patient against all odds.
Mr Ajay Singh a 40 year old
security guard fractured his hand few days was admitted in the emergency
department at Wockhardt Hospital in a poor clinical condition. He was brought
on ventilator support and had also suffered traumatic
head injury to his head and was in semi-comatose state. No pulse was felt in
his upper arm limbs. Dr Girish LBhalerao an experienced orthopaedic surgeon at Mira Road Hospital examined the
patient. On observation by Dr Bhalerao patient has severe injuries to his arm and
skin was removed (fasciotomy). The skin had in due course turned blackish brown and showed signs of
deterioration or ischemia. His fingers were dark blackish blue showing signs of
reduced oxygen and blood supply to the arm.
Patient’s condition was deteriorating and vitals had
reached a critical level. The blood pressure was dropping, pulse was racing and
he was severely dehydrated. Blood reports showed that the kidney was shutting
down. Patient was also suffering with uncontrollable diabetes, alcohol
withdrawal symptoms and electrolyte imbalance.
Dr Bhalerao diagnosed the
patient with impending compartment syndrome due to
fracture of humerus. The fracture had reduced blood circulation to the forearm and fingers.
He had oedema (fluid accumulation) cyanosis (bluish discolouration) spreading
to the chest area.
Though patient was of poor
financial status Dr Bhalerao spoke, to relatives of the serious condition of
the patient and that it was now imperative that the patient be moved to the
intensive care department for managing the case more effectively and prudently.
Dr. Manish Hinduja and ER doctors
Dr Sharad and Dr Hazel assisted Dr Bhalerao to alleviate the dropping health parameters
and status of patient. However due to certain falling health parameters
diagnostic investigation could not carried out as it might be risky. Doctors
had to rely solely on their clinical judgment and skills to manage the patient.
It was decided that the fracture site needed to be explored with surgical
intervention.
The next course of action due to complicated
nature of the fracture he case was orthopaedic surgical intervention by Dr Girish
to explore the fracture site and to determine the cause of poor blood circulation.
Patient was brought in for
surgery to fix the fracture and decompression of the compartment at the OT. On
exploring the site Dr Girish observed that the fracture was impinging on major
arterial vessels in the forearm and arm causing the occlusion of the vessels.
Dr Girish not only repaired the fracture but isolated and restored the damaged neurovascular bundle. After the repair Dr Manish Hinduja assessed the blood circulation in
the arteries in the arms and confirmed that the circulation was restored. Embolectomy was not required as blood flow was re-established in the limb.
Within 24 hours the patient
condition improved and all vital parameters including blood profile was
dramatically improving. Patient’s condition was reaching a stable condition.
The trauma site was recovering well.
On recovering Mr Ajay was very
grateful to all the team of doctors, especially Dr Bhalerao and Dr Manish at Wockhardt
Hospital. It was a complete team effort with commendable efforts put in by the emergency
medical services, intensive care services and operation theatre for promptly
managing the case and saving the patient’s life He also appreciated the overall
management and logistic support by the hospital for his care and medical
intervention.
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