Mid Air Emergency At 38000 feet.
Swissair flight - Mumbai to Zurich, had taken off at 2 am. It was about 3.45 and we were cruising at 38000 feet. We were flying to New York to meet our daughter Soniya.
There was an announcement on the PA system urgently asking for any Doctor on board. There was a medical emergency on board. I got up from my seat and summoned the support staff. I am a Neurosurgeon and am not accustomed to attending medical emergencies involving the cardio-respiratory systems. I cross my fingers and hope that the situation is salvageable. I'm quickly ushered to the patient, who was slumped in her seat, about 10 rows ahead of my seat.
I noticed that she was an elderly lady, straining to breathe, and was cyanotic. (Bluish discoloration of the lips and finger nails due to decrease oxygen concentration in the blood). I checked her pulse which was fast and thready. She was almost semi conscious, and was not responding to verbal commands. Her breathing was laboured, and there was an audible wheezing sound as she was struggling to breathe.
I asked her relative, who was anxious, pale faced, and distraught, about her medical history. He told me, that she occasionally suffered from asthmatic attacks. They however did not have the broncho dilator Aerosol spray.
I was in a quandary. I was hoping that there might be another Doctor on the flight, who could really have been a help, but no such luck. I was the only one and had to get down to work. I asked the flight attendant to get the emergency drugs box. He obliged and quickly fetched it. It was sealed. I asked him to open it and rummaged through the injectable drugs looking for any broncho dilator. I could not locate the routine salbutamol, aminophylline, adrenaline. Time was fast galloping, as was my own heart. I finally located inj. Hydrocortisone. This steroid was the best, that was available. I located a syringe, and needle, and quickly loaded the drug from the vial. The most dicey part was finding a vein, and getting the needle into the vein. There was some turbulence as I asked the attendant to tightly squeeze the ladies arm in an attempt to engorge the vein in the forearm and the front of the elbow. I chose one that seemed accessible and with a prayer on my lips, I punctured the skin and pushed the tip of the needle in the direction of the vein running parallel to it before giving a sudden jibe from the side to enter the vein. The Almighty took mercy on me as I watched the dark deoxygenated blood swirl into the syringe. I was spot on. I thrust the plunger gradually to deliver about 100 mg of the Hydrocortisone. I was praying to the Lord. The wheezing of the patient was audible to the naked ears. As the drug entered her system, I had asked the attendant to monitor her pulse. So far so good. The last ml of the drug was pushed and I quickly pulled out the syringe.
The next few minutes were tense. But the wheezing started diminishing, as the bronchospasm was being relieved. After about 7 to 8 minutes, the asthmatic attack was fully aborted and her breathing became almost normal. I heaved a sigh of relief. Later, I was told that as we were flying over Iran, we did not have the option of landing anywhere nearby and w would have had to return back to mumbai, which was a good 2 hours. All is well that ends well. What really is most touching is a message that's religiously sent on occasions such as Doctors Day, by the relatives of the patient. It makes these efforts so worthwhile and the gratitude of the patients kith and kin really is very humbling. Sharing the message, I received today on the occasion of Doctor's Day.
I requested the patients permission to share his message and he obliged.
Dr. Deepak Ranade.
Dear Dr Ranade,
Happy Doctors Day ...
A big thank you from the bottom of our hearts ....
This is just one day to put in a few words though we thank you every day ....
We always talk so much about you ... the way you saved her on board the Swissair flight on way to US.
God bless you and your loved ones.
Mummy, Urvashi, Capt Ashok Dhawan
Deepak, I remember you and your wife were going to give a surprise to your daughter in US on her engagement .... have the kids married or still enjoying their courtship days.
God bless them.
Ofcourse, you can share on FB.
Please keep our name ... we are really thankful to you and always take your name proudly of a what a “True Doctor” with a heart is.
Swissair flight - Mumbai to Zurich, had taken off at 2 am. It was about 3.45 and we were cruising at 38000 feet. We were flying to New York to meet our daughter Soniya.
There was an announcement on the PA system urgently asking for any Doctor on board. There was a medical emergency on board. I got up from my seat and summoned the support staff. I am a Neurosurgeon and am not accustomed to attending medical emergencies involving the cardio-respiratory systems. I cross my fingers and hope that the situation is salvageable. I'm quickly ushered to the patient, who was slumped in her seat, about 10 rows ahead of my seat.
I noticed that she was an elderly lady, straining to breathe, and was cyanotic. (Bluish discoloration of the lips and finger nails due to decrease oxygen concentration in the blood). I checked her pulse which was fast and thready. She was almost semi conscious, and was not responding to verbal commands. Her breathing was laboured, and there was an audible wheezing sound as she was struggling to breathe.
I asked her relative, who was anxious, pale faced, and distraught, about her medical history. He told me, that she occasionally suffered from asthmatic attacks. They however did not have the broncho dilator Aerosol spray.
I was in a quandary. I was hoping that there might be another Doctor on the flight, who could really have been a help, but no such luck. I was the only one and had to get down to work. I asked the flight attendant to get the emergency drugs box. He obliged and quickly fetched it. It was sealed. I asked him to open it and rummaged through the injectable drugs looking for any broncho dilator. I could not locate the routine salbutamol, aminophylline, adrenaline. Time was fast galloping, as was my own heart. I finally located inj. Hydrocortisone. This steroid was the best, that was available. I located a syringe, and needle, and quickly loaded the drug from the vial. The most dicey part was finding a vein, and getting the needle into the vein. There was some turbulence as I asked the attendant to tightly squeeze the ladies arm in an attempt to engorge the vein in the forearm and the front of the elbow. I chose one that seemed accessible and with a prayer on my lips, I punctured the skin and pushed the tip of the needle in the direction of the vein running parallel to it before giving a sudden jibe from the side to enter the vein. The Almighty took mercy on me as I watched the dark deoxygenated blood swirl into the syringe. I was spot on. I thrust the plunger gradually to deliver about 100 mg of the Hydrocortisone. I was praying to the Lord. The wheezing of the patient was audible to the naked ears. As the drug entered her system, I had asked the attendant to monitor her pulse. So far so good. The last ml of the drug was pushed and I quickly pulled out the syringe.
The next few minutes were tense. But the wheezing started diminishing, as the bronchospasm was being relieved. After about 7 to 8 minutes, the asthmatic attack was fully aborted and her breathing became almost normal. I heaved a sigh of relief. Later, I was told that as we were flying over Iran, we did not have the option of landing anywhere nearby and w would have had to return back to mumbai, which was a good 2 hours. All is well that ends well. What really is most touching is a message that's religiously sent on occasions such as Doctors Day, by the relatives of the patient. It makes these efforts so worthwhile and the gratitude of the patients kith and kin really is very humbling. Sharing the message, I received today on the occasion of Doctor's Day.
I requested the patients permission to share his message and he obliged.
Dr. Deepak Ranade.
Dear Dr Ranade,
Happy Doctors Day ...
A big thank you from the bottom of our hearts ....
This is just one day to put in a few words though we thank you every day ....
We always talk so much about you ... the way you saved her on board the Swissair flight on way to US.
God bless you and your loved ones.
Mummy, Urvashi, Capt Ashok Dhawan
Deepak, I remember you and your wife were going to give a surprise to your daughter in US on her engagement .... have the kids married or still enjoying their courtship days.
God bless them.
Ofcourse, you can share on FB.
Please keep our name ... we are really thankful to you and always take your name proudly of a what a “True Doctor” with a heart is.
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