Later in the evening, around 11 pm, I remember walking around the halls by the make shift supply room, when out of the corner, Bernice who is a part of our team told me that I needed to prepare for surgery for a young woman who was 20 or so weeks pregnant, who's unborn child died during the earthquake, after a cinder block fell on her. Bernice, who happened to be a nurse midwife was working the night shift and was watching this patient on the other side of the hall in another room with two other OB/GYN surgeons, who've been trying to "induce" her, so that she could give birth naturally to her already deceased fetus.
After so many hours of unsuccessful waiting, she apparently started losing a lot of blood. Her condition was worsening and they decided to perform an EMERGENCY CESAREAN SECTION!
Being the only anesthesia provider who was working that night, I had to scramble for help. Helen, turned out to be knowledgeable on gathering the necessary surgical instruments. Bernice volunteered to assist the 2 surgeons, and Luc was a trained O.R. nurse. Everything happens for a reason! Everyone who needed to be there, was there!
I ran to check the two operating room's anesthesia machines. One of them had an oxygen leak! Luckily, these old machines are the same ones that I trained on back in Ohio! I was able to trouble shoot the problem! But, it still had a leak! Can't use this one! So I ran next door to the other operating room and saw that the other anesthesia machine was completely disabled too! I needed to think of a way to perform general anesthesia on this patient, who was deteriorating quickly.
After seeing a huge oxygen tank on its side on the floor, it dawned on me that they probably weren't using the machine at all! I decided to manage her anesthesia with intravenous drugs only and with manually controlling her ventilations without a ventilator.
The next thing I recall was that the patient (Madeleine) who was still on her OB exam table, was wheeled into the room by both surgeons. They hurriedly prepared for surgery and waited for me to put her off to sleep and help control her breathing. The one thing that I will never forget.....is that despite the fact, that she knew her unborn child was already dead, she looked at me with her beautiful eyes, and gave me a nice big smile and said, "Merci" (thank you). I told her through the help of her interpreter to take a big deep breath, as I caressed her cheek, and put her off to sleep.
Once she was asleep, I told the surgeons to go ahead and "cut". Meanwhile, I was busy looking for medications that I needed during the operation. I asked Luc to ventilate the patient for me while I scrambled for some much needed medications to help sustain her during the operation. Another nurse helped me write down important blood pressures, etc.
Both surgeons worked expeditiously to get her unborn fetus out and help control her internal bleeding. They did the surgery in 20 minutes! She was becoming more stable! Thank goodness! Once the operation was done, her unborn fetus (a boy) was given to her husband who was waiting in her room. It was a sad night for all of us. Yet, I was very happy that Madeleine was able to pull through! Once she was awake and stable, we took her to the recovery room. I helped watch over her, along with the other 2 critically ill patients the rest of the evening.
Everyone tonight did a great job! We pulled through! Waited for the day crew to arrive and gave my report over to Brenda. The rest of my night shift crew went back to the house after getting a light breakfast (Chef Boyardee!). Saw the sun rise from the hospital balcony with Janet. What a beautiful site!
Once back in the house, Luc and I talked a bit about what had happened on our first night there. I was still too wound up on adrenaline to sleep. But I needed to get some rest for the next shift. I was assuming that I'd be back at the hospital again tonight...
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