Over 3 hours, over 200km to save the patient who is predicted to die

Before that, on the afternoon of March 1, the Intensive Care Center, Bach Mai Hospital received an emergency consultation from the Intensive Care Department, Yen Bai Provincial General Hospital about the case of VTH patient (28 years old). healthy history, diagnosis of severe anaphylaxis, complications of multi-organ failure.

The day before, Ms. H. had just had a 39-week cesarean section at another hospital. During the operation, the patient’s blood pressure dropped, doctors suspected anaphylaxis, emergency treatment according to the protocol, endotracheal intubation and mechanical ventilation. The caesarean section continued, successfully taking out a baby boy weighing 3.5 kg.

However, after the cesarean section, Ms. H’s blood pressure dropped again, and her breathing difficulty gradually increased, so she was transferred to Yen Bai Province General Hospital, predicting death. The patient is maintained with high-dose vasopressors and has a very poor response, a very high risk of death, and is not safe enough to be transferred to a higher level. The Yen Bai bridgehead requested Bach Mai Hospital to support the placement of ECMO (artificial heart and lung) for the patient.

Resuscitation on the way to transport patients from Yen Bai to Hanoi nearly 200 km

After quickly discussing the progress and condition of the disease, the Center for Active Resuscitation in collaboration with the Training and Directing Center (Bach Mai Hospital) quickly dispatched an emergency mobile Resuscitation team to go to Yen Bai. – 200km from Hanoi.

At Yen Bai Provincial General Hospital, doctors coordinated, assessed the patient’s condition and agreed to make a diagnosis and immediately entered ECMO. This is the last resort to bring hope to the patient.

At 18:00 on the same day, Ms. H. was safely admitted to ECMO. At 20:10, the patient’s clinical condition allowed, the Mobile Resuscitation Unit began to transfer the patient to Bach Mai Hospital for further monitoring and treatment.

On-site resuscitation was difficult, resuscitation on the nearly 200 km transport route was not a simple problem. From the time Bach Mai Hospital received a phone call asking for support from Yen Bai General Hospital to the completion of ECMO, less than 3 hours and 15 minutes (including preparation time, traveling about 200 km). ). Without good coordination between doctors and nurses between hospitals, it is difficult to save the lives of critically ill patients.

Doctors deploy ECMO technique – the last resort to bring hope to patients’ lives

At the Intensive Care Center, Bach Mai Hospital, patient H. continued to receive ECMO, high-dose antibiotics, resuscitation and mechanical ventilation. The patient’s condition gradually improved.

At 6pm on March 6, Ms. H. had a lot of abdominal pain, low blood pressure, ultrasound showed a lot of fluid in the abdomen, aspiration probed out blood. The patient was consulted and diagnosed: Hemorrhagic shock – Intra-abdominal bleeding – Anaphylaxis / After the second cesarean section, emergency surgery. After exploratory laparotomy, it was discovered that the patient had a ruptured bladder causing a lot of bleeding in the abdomen, the doctors carried out suturing blood vessels, sutured the bladder, cleaned the abdomen and placed a drainage tube.

On March 7, the patient was awake, ECMO was performed and the endotracheal tube was extubated. The patient continued to receive treatment and care at the Intensive Care Center from March 8 to March 21. Health This mother is getting better, eating, exercising, and having drains removed.

At present, the female patient has completely recovered, her liver and kidney functions have returned to normal, echocardiography is good, cardiac function is good, there is no thrombus, she can eat and drink. On the afternoon of March 22, she was discharged from the hospital in the joy of her family and doctors.

Ngoc Trang