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I GOT SUCKED INTO A DOOZY!!!From: mark decker (mdecker@nconnect.net)Mon May 27 23:02:39 1996
this saturday at 10 pm I got a call from the ob gyn doc on call in the neighboring community. she was having trouble with a 22yo primip with uterine atony not responding to pitocon or methergine. lost 4 units or so by the time of the call. I suggested hemabate <f2alpha> and she said she'd call if she needed help. well she called back and wanted help to ligate vessels. about twenty minutes later I got there and I ligated the uterines without difficulty...she had controlled/slowed the bleeding by direct pressure on the vessels but if she let go it bled like hell prior to the stitches and her help on this holiday weekend was not savvy enough to hold while she sewed. it went well but still flaccid with multiple methergine and hemabate and pitocin. little oozing with the vessels tied off. but she oozed enough we packed her..sewed her up and the patient went to the recovery room with good pressures <105-110/60-80>, jean called me today...anesthesia doc <not allowed usually to to ob anesthesisa just gyn cases due to past incidences> used flurane for the general <he does not do epidurals or spinals I am told>...and apparently 2 other things he did or did not do were suspect.. patient arrested in the recovery room after I left for and was at home. she is a legal secretary for a law firm in milwaukee <not far from where I practice. jean was on call for her partner and never saw the patient before labor and delivery..I have never met her awake as I was only surgically involved and she was taken by flight for life to the tertiary center where the chart was reviewed by ob and anesthesia to figure out what went wrong. patient dry as a bone so to speak after tranfer//apparently no ill effects from the code? have a good memorial day holiday. patient did not but I am glad she's ok now. I will have to brush up on gases that are ok and those that aren't..we do not have flurane in our anesthesia dept at my institution and the anesthesia 4 crna's are very very god and up to date..so good I rely on them to make the correct choices..need to stay up on top as this case goes to show. mark decker md major surgery is done on me obgyn minor surgery I do one someone else. west bend wi I need to remember that. <perspective>.
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