Tuesday, November 26, 2013

moving and BiPap

I know my last post was medical and I said my next one would be more about life so I will start by saying I moved this weekend. Since arriving at Tenwek I have been living in the home of one of the long term missionaries who was in the states for a year. She returns this week so it was time to move out. My roommate had left a few days earlier so that left me to pack up the house, most of it was mine anyway. My new home is right next door to my current one, which you think would make moving easy, just a few steps. However there are currently people living in “my” house who will be there for another month. So I have moved to a temporary home. This is the biggest place I have lived in yet and the walk from the kitchen to my bedroom feels long. I was thankfully able to move many of my things from my former place to my future place to store in the bedroom, however, I now have things in storage that I wish I had access to. It’s one ofMurphy's laws that you do not need something until it is placed in storage. So the weekend was spent moving and now that’s mostly done and I have been back to work.

I always find it interesting how things at the hospital go in trends, currently we are on a Bipap trend. Bipap is a way of helping someone breathe without putting a tube in their throat. Before I came it was done infrequently but we keep using it more and more. We have a few “home” style bipap machines that work well for some of our patients but they don’t work well for our patients who need a high percentage of oxygen. For these patients we would have to intubate and place them on the ventilator. However a few weeks ago when we had an elderly, hypoxic, COPD patient who I really did not want to intubate  I tried something different. I hooked the bipap mask up to the Servo 900C ventilator and popped it on the patient. It worked like a charm I was able to set the sensitivity so it would not autotrigger, the alarms were easy to set and that patient did well. Since then I have used the servo 900c for multiple patients as a bipap machine and it has helped save many lives. Earlier this week I had a young man who developed a PE and consolidation after he was in a motor bike accident. This man was fully awake however his oxygen levels were low despite oxygen via non rebreather mask. Rather than intubate him, onto bipap via servo 900c he went for 24 hours and then he was fine.   I am thankful for the machines I have to use and the ability to use them for various purposes.
BiPap via Servo 900C

In  closing I ask for prayers for a few patients I intubated a 6 month old (the first time I have intubated a baby) and she is very sick and we are not sure why. Please pray she will recover. We also had a young lady come in the other day after a motor bike accident and her leg had to be amputated, Picture is below, don’t look if you can’t handle gross medical pictures. 
to give reference the tourniquet is between her thigh and where her knee should be

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