Saturday, May 15, 2010

Whatever you do, don't call an ambulance!

Yesterday night I was taking care of our precious Orlin, the baby who I wrote of in my last entry. He seems to be doing a bit better, but continues to have recurrent lung infections. He has been out of the hospital for a week now. Praise God for that!

When I was just about to leave from watching Orlin, I got a call on the radio from one of the nurses in the hospital. A two year old boy, Anyel, had gotten into his mother's iron pills and had swallowed thirty tablets: a lethal dose. He had suffered convulsions in his home, which prompted the mother to bring the child to our hospital about 5 hours after he had ingested the tablets. At that point it was too late to try to induce any vomiting of sorts. Our hospital did not have the medicine needed to excrete the iron from the body, so I was being called to help transport him via ambulance to a large public hospital in La Ceiba.

There are 5 stages that a person goes through when they have overdosed on iron. In the first, the patient will usually experience gastrointestinal symptoms and convulsions. It is common for the patient to be bleeding in his stomach and intestines, which causes death in a significant percent of victims. The next phase, is deceptive in that most symptoms subside, and the patient appears stable. Within hours, however, the patient enters the third stage where low blood sugar, cardiac problems, shock, and coma often occur. This usually happens within 6-8 hours after ingestion. Most patients do not make it through this stage. If they do, they enter the fourth stage which is when the patient presents liver failure from the damage that the iron has done as the liver tries to filter out the toxins in the blood. Lastly, if the patient makes it through all of that, he must then deal with the residual gastric problems, which sometimes warrant surgery.

When we began transport, our patient was in the deceptive Stage 2. He was still vomiting and stooling blood, but he was at least alert and oriented. Knowing that he could begin to present cardiac symptoms at any point, and possibly go into coma or shock, I was extremely nervous about the hour ride ahead of us. I had no idea that by the end of the trip, I was going to be fearing for not only this baby's life, but also the lives or all of us in the vehicle.

The first half of the trip was on dirt roads. We sped along and cut corners as we went. Apparently the driver was determined to not allow anything to slow him down: not heavy rains, not terribly fogged windows, not even losing control of the vehicle on the slippery mud roads. I maintained my hand on the Anyel's pulse, and my eyes on the road, as my attention quickly became divided from that of the life of Anyel to also the lives of all of us in the vehicle. Penny, the nurse accompanying me refused to look at the road at all. It was so scary!

FINALLY, the rain subsided and we reached paved road. I breathed a sigh of relief, not realizing that these better conditions only meant more risky driving. We sped along, not stopping for anything or anyone: not even a semi-truck. Nope, we didn't budge one bit as we drove in the oncoming lane of traffic, and the semi came fast approaching. Thankfully the truck decided to drive into the ditch rather than smash into us at the last second. I can't count how many other times we pulled directly into oncoming traffic. I knew it could be the end for everyone in this...ambulance?

But we made! Alive! Anyel was hard to awaken and barely responsive when we arrived. Thank fully the hospital was expecting him and he was seen immediately. We found out that the medication that he desperately needed is no where to be found in the entire country. So we left, feeling a bit disheartened.

The following day, this past friday, he was visited by some of our staff. The doctors explained that his iron levels are about double where they should be, but they are lower than what requires drastic intervention. Anyel was not alert or responding much when they visited.

Please pray for him, as he is still in a very critical state. I will be posting more updates as I get them.

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