CPR in time, saves life.

SAVIOUR IN WHITE COAT AT 25000 FT ALTITUDE

Always scared of air travel …..
Why and How?
Is it a phobia!
Phobia of what?
Altitude or just an attitude towards Seat belts, nausea, vomiting, air turbulence, closed pressurized chamber, security briefing and sitting in a small place and what not. A-320 airbus, cruising at a speed of 600 odd kilometers an hour at an altitude of 25000 ft with outside temperature of -35 degree Celsius….as Ishita, the pilot-in-command announces, it triggers a spine chilling sensation. So many stresses in flight, for sake of sparing precious time with no comfort and you sail through air and touch down while keeping Jaws clinched with palpitation as if you yourself are landing barefoot on a bare belly at a high speed of 300kms per hour.

It was assembly election time in Madhya Pradesh, a central state of India when I got news that my aunt died of carcinoma buccal mucosa because of tobacco chewing. Being a physician, kept asking her to quit but her 36 years of hardcore tobacco chewing laid her life rest in peace untimely. My superior allowed me a leave of just 2 days to go around 1000 km away from Indore to Kanpur and attend the final rituals and come back as electioneering is on and Model Code of Election Conduct is implemented and leave of not more than 2 days is simply not allowed to anyone. Grim face, I got out of office and took the road route to Bhopal and boarded a train, GaribRath Express to Kanpur on 14th October 2018 which is a fully air conditioned train run for all and sundry with a very economical fare.
All night I could not sleep as I kept recalling my childhood when my maternal aunt got married to my maternal uncle. Being young lad of 16, I was asked to be her companion as the marriage ceremony took place at Tatanagar, an Eastern Indian city and we came back home to Kanpur after covering about distance 1200 km by Chartered Bus way back in 1982. And now after 36 years of marriage she is no more. With Tears in eyes attended last rites for her heavenly Abode.

I Came to Lucknow airport next day to get back home to Indore via Hyderabad. Air travel is time saving but much of time is wasted for security reasons before the takeoff and after the Touch-Down as you are back to normalcy. Tired, I sat and slept immediately as the Airbus A320 6E-884 took off at around 3:10 p.m. on 16 October 2018. Sailing smooth and sleeping well, Amygdala in brain woke my consciousness as my subconscious mind registered, someone screaming “any doctor on board”…. “any doctor on board” on 3rd shout I took out my neck in the aisle and showed my thumbs up while looking at the back of the aircraft from my 27D seat where air hostess was standing. She asked, are you a doctor?
I nodded. Sir, please come fast here is an emergency…. and through that aisle we almost ran to 6B seat. A while ago only at around 30000 feet altitude, the Pilot in Command had switched on seatbelt sign and lights were dimmed and dissent to reach Hyderabad Airport was already started.

An old lady in Grey sari with seat belt in place, Bhanumathi Bhagat was just sitting idle …. No response to verbal commands of her son and husband who were sitting on either sides of 6B seat. I saw her wrinkled but graceful face with a small Bindi on forehead and necklace. As I hold her hand to find out radial pulse ….. No pulse, took a feel of Carotids in neck… No pulse. Time was running out. Asked air hostess to get me a BP instrument and stethoscope. One of them rushed to their flight console to get these. I put the pressure at supraorbital Ridge to compress supraorbital nerve which is always ready to give an immediate awakening pain stimulation and subsequent response is always received …. No response to pressure.

Now it was my turn to sweat I touched her Limbs, they were cold and clammy my subconscious mind gave me this negative clue that she is no more but conscious mind which is trained for such situations took over and hastily got her to lie on 3 seat row with her foot end raised and placed on the lap of her husband at seat 6A.

Got her chest on 6A as her head in aisle held by her standing son and straight away chest massage was started by me. Her son got hold of her hanging head as I continued giving massage. CPR or cardio pulmonary resuscitation has got a profile of saving life and a procedure protocol says to get the patient on floor and sit beside him in Savitri Aasan (Standing on knee) and keep your elbow straight with crossed fingers of both the hands to get one unit of both the wrist (Savitri Mudra) and give chest compressions followed by mouth to mouth breathing.

Forceful push of air is must which are known as rescue breathing(Ideally 100 chest compression per minute). For all this procedure Airway in neck has to be straight for uninterrupted Air supply. While having her head suspended in aisle straightness of airway was ensured and chest pumping by Doctors hand triggered an electrical stimulation to SA node of heart and in nick of time heart restored its heartbeat.

Miraculously heart pumping started and blood started flowing, gushing and pumping through the vessels of the head, lungs and all over. Head being at low level recieved fresh bout of blood immediately thereby leading to awakening of this human machine and got it started and let her open her eyes just like car keys are turned to ignite the car engine. She opened her eyes and gasped to fresh air.

All air hostess along with co-passengers around who were watching with wide open eyes took a surprising sigh of relief. A big and Sunny Smile was on every face as if they themselves have been saved by this magical technique called CPR and I being a doctor was having my own heart pumping and thumping like a racing horse. Patient’s pulse which was feeble and low volume and BP was recordable though low but maintained.

Pilot asked through air hostess, Is everything alright or you need a Priority landing? Assured, she is all right now but will prefer priority landing and the cruising aircraft was to touch Hyderabad Airport on a Priority. All aircrafts approaching the airport were asked to standby by ATC Hyderabad and A320 Lucknow-Hyderabad 6E-884 landed safely with revived patient on board at 25000ft luckily and strangely. An ambulance was ready to pick her up for further management as the Airbus came to standstill at the tarmac.

One of leader Air Hostess announced on mike, Dr Bhadoria has saved a life today on board and this old lady of 76 years is all smiling now after knocking the doors of pearly heavens. Co- passengers made a loud roar and clapped for appreciation and later as I was trying to approach my seat to pick cabin baggage up people around were coming forward to shake hands with me and the feel was ecstatic. Life saving has been my bread and butter since last 27 years but no such feel ever was felt by me. Saviour’s efforts save a life at 25000 ft altitude and inadvertently save the image of medical profession as well where corporate hospitality in medicine has tarnished image of profession.

One can say, medical profession is thankless for such rare incidents but the almighty has given a chance to let her live for few more years. At the same time this doctor thanked almighty for choosing him to be a savior at 25000 ft. Heartfelt gratitude to the supreme soul …..the almighty.

LINK ATTACHED

http://www.mymedicalmantra.com/in-flight-doctor-successfully-resuscitates-unconscious-woman/

By Dr Anil Kumar Bhadoria, from Indore

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