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Monday, February 8, 2010

THE TRACHEOSTOMY DREAM!

DO ANAESTHETISTS DRAEM? OFCOURSE, THEY DO. AFTER FINISHING A BUSY PEDIATRIC LIST, AND WHEN THE END TIDAL SEVOFLURANE CONCENTRATION EQUATES MAC, ANAESTHETISTS MAY TAKE A DOZE AND DREAM. HERE IS AN INTERESTING DREAM "STORY", BY AN ANAESTHETIST.

I was sleeping..... and i heard some noice outside my duty room, its like shouting or banging at the door by some one, i got up cursing my time, opened the door and found three people, one female and two males, gazing at me,furiously.I could see all of them were covering their neck with their hands. I asked, whats the matter? they said, "we are already dead and reached our final destination, means to GOD almighty, and we were sent back to earth. We were treated by you in icu, when we were critically ill on ventilator. Its you!  its you!, who made these holes on our necks, and they removed their hands covering neck. I was surprised to see that, all of them were tracheostomised with the holes still persisting! They then told me that, all of them were allowed to enter heaven by god, but the god's assistants refused their entry just because of their holes on neck as such a deformity is not expected for anybody coming to heaven, and told them we can go to hell if we wish. We were asked by these servants of god, to go back to earth and meet those people who made this deformity to us and find a solution, So we are sure, you are responsible for this as you gave consent for tracheostomy and so should find the solution also.

I was totally confused, and i tried to convince them that, eventhough i gave the consent, the decision to operate was taken by the ENT surgeon and he did the procedure, and i just supported him thinking that this will improve your clinical condition.But unfortunatelly all of you were critically ill and we couldnt save your lives. So please go to the ENT surgeon and ask for help.

They nodded their heads and immediately disappeared, after sometime again i heard knocking sounds at the door, i opened the door , and i found them again. this time one more person also present with them, and that was the ENT surgeon. The surgeon told me, some how it happened, and now we have to find a solution. only you can help me. We asked our visitors to wait for some time mean while discussed the possible ways to correct the deformity. We came to a conclusion to put an endotracheal tube to cover up the deformity as lost tissues cannot be made. So we took them to OT again and intubated. they were very happy and left.

Again after some time, all the three appeared in front of my room, and said this is also not accepatable there as it is artificial. This time me and the ENT surgeon were in a dilemma on what to do? At last we were forced to do a full tracheal reconstruction surgery to all of them, with the help of our thoracic surgery colleague. Again they left happily and never reappeared!

         WATCH  TRACHEOSTOMY VIDEO

2 comments:

drsreejith, muscat said...

nice story,but percutaneous tracheostomy would be a better option in critically ill patients, and of course leave a small hole compared to conventional tracheostomy.also decannulation is early and leave less scar.

Anil said...

I can only but sympathise with the ENT surgeon. The decision to operate in ICU is always somebody else's but we have to borne the results. But I am sure, it is true that the scar after a tracheostomy is ugly and we should try for something better, like PCT.
Dr Anil Safaya
Ibri