Re: Triplet management
From: art fougner, md (evsono@pipeline.com)
Thu Nov 2 11:49:42 2000
Do you have 3 ventilators and staff sufficient to care appropriately for
3 preterm newborns? if not - i suggest you get a move on.
art
At Thu, 2 Nov 2000, Latisha Lochabay CNM wrote:
>
>Thanks so much for the replies - tongue-in-cheek and otherwise. It
>helps relieve the stress.
>
>1. Why can't we transport? We are a US commonwealth - Commonwealth of
>the Northern Mariana Islands - an hour from Guam by air - in the middle
>of nothing but lots of ocean. Because this patient is not a US citizen
>and does not have a US passport, we cannot transport her to an American
>hospital anywhere (ie Hawaii, Guam, stateside). Her option was to
>return to her native country which she declined to do. There are lots
>of immigration issues at hand here. We looked at transport several
>weeks ago before PTL started. It was a no go.
>
>2. Bringing in the big military guys with their excellent crews and
>jets is a great idea - one that costs a fortune.
>
>3. We do have a neonatalogist and a small understaffed NICU.
>
>4. Yes, we are very aware that it is best to transport in utero.
>
>5. We've had her on complete bedrest, mag drip, indocin, ampicillin,
>and she's had two doses of betamethasone in the last 30 hours. Cervix
>is unchanged - still 3/90%. She's hanging in there. All babes look
>pretty good.
>
>I came here from a tertiary care center/teaching institution in
>Tennessee. I was used to having everything possible at my fingertips.
>Earlier this year, here on Saipan, we successfully managed a
>hemodialysis patient through pregnancy and delivery. We see lots of
>high risk and we have good outcomes. Triplets are new for us though.
>
>I guess this isn't the perfect time to let y'all know that we are
>looking for 6 month to 12 month locum tenens OBs. :) Yes, it is a
>roller coaster ride, but it is worth the trip.
>
>--
>Thanks,
>Latisha Lochabay CNM
>Commonwealth Health Center
>Saipan, Northern Mariana Islands
>
--
art fougner, md
A series of 1000 cases begins with but a single anecdote.
