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A design for intubation tent in times of COVID

Posted by: Philip Alex | Posted on: April 5th, 2020 | 0 Comments

The pandemic that is sweeping the world is unforgiving and relentless at present, confronting health workers with the highest risk of exposure and infection. Of the segment, those in intensive care units exposed to those who need intubation are possibly at the apex of risk. Safe intubation will always be fraught with the danger of aerosol dissemination and cross infection.

To minimize this risk, we designed a simple intubation tent which can help minimize the aerosol dissemination risk to the operator. All other advocated measures, including personal protective equipment, N 95 masks, minimizing mask ventilation and early inflation of the balloon on the endotracheal tube are all to be practiced in addition to the use of this tent.

STEPS FOR USE:

  • This tent can be made with clear plastic, with two sleeves in it into which the operator inserts his hands, and then puts on an extra pair of gloves, in addition to the ones he or she is already wearing as part of the PPE. The gloves go over the edges of the plastic sleeve ensuring a good seal.
  • All equipment for intubation, including laryngoscope, suction, guedels airway, syringe for inflation of the cuff, and endo tracheal tube of the appropriate size are placed on the chest of the patient to be intubated.
  • The edges of the plastic are tucked under the mattress on three sides of the head of the bed, and the inferior edge is tucked under the patients bedcovers, so no air will escape into the room onto the operator standing at the head end.
  • The operator is able to see through the plastic to intubate the patient after the administration of appropriate relaxant via a peripheral iv access.
  • After intubation the cuff is inflated, and the suction utilized to suck out the air in the tent prior to disassembly.

This way very little  air from the patient will disseminate into the room to potentially infect caregivers.

Our photos showcase Mr Dhani Ram, our tailor who has created this tent.



STAY SAFE EVERYONE!

 

Covid 19

Posted by: Philip Alex | Posted on: March 25th, 2020 | 0 Comments

The corona virus outbreak is an unprecedented tidal wave that threatens the world. The threat is clear and present in Manali. We have taken precautions for our hospital and for our staff to deal with this wave when it does lash over us. 

  • All elective surgery has been suspended for now. 
  • Outpatient clinic will stay open with a fast track for all patients who present with symptoms of the flu. 
  • We will begin to restrict entry into the hospital facility shortly for relatives of patients, only one will be permitted. 
  • We have established counter number 13 for all those who want prescriptions refilled so they will not need to wait in the waiting room, but go directly to get their medicines. Medicines will be issued a month at a time or for longer periods if desired. 
  • All our staff will wear masks and gloves and maintain physical distance for all interactions except when direct patient care mandates close contact. 
  • Public are encouraged to stay at home and to come to the hospital only when absolutely necessary. They are advised to retain their elderly at home, and send their cards in for medicine refills in the hands of the young. 
  • Emergencies will be taken care of at all times. 

We pray for Gods mercy grace and protection as we arm ourselves to deal with this. 

Happy Pharmacy day

Posted by: Philip Alex | Posted on: September 26th, 2019 | 0 Comments

We are proud of our pharmacists who provide service to our patients and we are very glad that they are all now housed in a very nice environment and able to provide their best to the patients. Happy pharmacy day to all!

BLS Training for paraglideru

Posted by: Philip Alex | Posted on: June 12th, 2019 | 0 Comments

The Lady Willingdon hospital provided BLS training for paragliders on 12th June 2019. Lorna Sandison, a final year med student from the UK, organised this, including running half a marathon to procure mannequins for this training. Thanks Lorna! 

We hope through these sessions to train paragliders and taxi drivers in this region equipping them to handle BLS for any emergencies for which they are the usual first responders. 

Adieu to Dr. Dennis, Sharel and family

Posted by: Philip Alex | Posted on: June 12th, 2019 | 0 Comments

Dr. Dennis, our orthopedic surgeon, Sharel physiotherapy and community health will leave us to go to mission hospital Mungeli. We bid them an emotional bon voyage on 12th June 2019. 

Dennis first came to us as a medical student, and Manali saw him grow into consultancy, marriage and welcomed his children. They will always be part of us, and we wish them well as they embark on a new venture. 

Nurses Week Celebration at LWH May 2019

Posted by: Philip Alex | Posted on: May 7th, 2019 | 0 Comments

In commemoration of the Nurses Week, the nurses of Lady Willingdon Hospital, Manali have decided to raise public awareness about Tuberculosis.

Even though there has been considerable progress in the last decade, TB is an infectious killer world-wide and the drug resistant TB poses a major threat.

Today the nurses performed street plays in the town in an effort to raise awareness against TB. They will be going to all the schools in Manali to perform skits and talk to the Teachers and Children about how the disease can be prevented and treated thus giving them knowledge about accessing the right treatment, at the right time.

[caption id="attachment_3372" align="alignleft" width="300"] Introduction by Sis Prabhjyot Nursing In Charge of LWH[/caption]

[caption id="attachment_3373" align="alignleft" width="300"] LWH Team at Mall Road[/caption]

[caption id="attachment_3374" align="alignleft" width="300"] At the starting point[/caption]

Believer hospital students in Manali

Posted by: Philip Alex | Posted on: May 3rd, 2019 | 0 Comments

We welcomed the medical students from Believers Hospital in Kerala to our hospital where they performed their elective posting. Thank you for coming. They were led by faculty Dr. Ashvin and Dr. Karuna. 

 

 

 

 

 

Leopard attack

Posted by: Philip Alex | Posted on: March 3rd, 2019 | 0 Comments

Manali village folk are not strangers to animal attacks. We have had patients mauled by bears before, though the frequency has been decreasing. Yesterday, we received a 69 year old gentleman who was attacked by a leopard near the old manali bridge. Leopards prowl the forests but rarely descend to human habitation unless they are desperate for food. The predator had come to include some dog meat into his diet. He attacked the elderly man. The man himself was no stranger to forests, having spent his life as a shepherd and jungle forager. Other companions fled, leaving him grappling with the beast. He had the presence of mind to catch the cat by the throat and push him off, though the beast had the mans head in his mouth. He further had the presence of mind to play “dead”. The beast did not fancy human meat on his menu, and so wandered off. 

The man was brought to us with his left eyelid ripped off, frontozygomatic fracture, multiple scalp lacerations and a chunk taken out of his left upper arm. We were able to fix him up and reconstruct his left upper eyelid, while listening to the story of the mans bravery and past exploits. Thankfully his eyeball was intact, though the conjuctiva was torn. 

The leopard was later tranquilised and carted off to safer hunting grounds in Palampur by the forestry department. 

Man and beast stood their procedures well. 

Kudos to the brave heart of Old Manali. Any lesser man would probably have been cremated by the evening. 

[youtube]https://youtu.be/J21rHKT2USw[/youtube]

Rural surgery

Posted by: Philip Alex | Posted on: February 17th, 2019 | 0 Comments

Ms. X was a young lady who presented to us with altered sensorium after a fall.  She was arousable but not responding  relevantly and there was a difference between the size of her pupils. A ct showed a huge extradural hematoma pushing the midline across to the other side. This is a life threatening condition and needs immediate surgical attention. 

Today in any city she would be referred to a neurosurgical centre. The centres in most cities are in large tertiary hospitals, mostly corporate in nature. Government facilities that handle cases of this nature are in capital cities. Most district hospitals will refer to state capitals. This will invariably mean further travel, time , and money, all scarce resources that further jeopardise the chances of survival. 

What does a doctor in a rural hospital confronted with this situation do? 

The breadth of the art and science of basic surgical training has departed from the curriculum of the general surgeon today, abdicated to the genre of specialist surgeons. Not that the specialist surgeons do not have elective rights over such surgeries, but I enter my plea that general surgeons also need to be equipped with skills and science to handle such situations on emergent grounds. 

We were able to evacuate this hematoma. There was a sagittal sinus bleed which was controlled with difficulty. The lady left us with no residual deficit. While I write this, I testify to what I call the “G factor”, which operates in situations where we have no one else to turn to. In my fifteen years of work in this place, I testify to the healing that comes from God. This operant factor may get displaced into the wings by “advancement” and technology, but in their  absence occupies centrestage. 

What does rural India need to handle such emergencies? Referral is an abdication and a wilful death sentence inscribed with every stroke. I am not a neurosurgeon, but I was trained at Christian Medical College Ludhiana to handle such emergencies. Are our young surgeons of today being similarly equipped or denied the skill under the guise of a sacrosanct speciality? 

What do we do as faculty to equip our surgeons for the rural patients of tomorrow? 

 

Let it snow!

Posted by: Philip Alex | Posted on: January 14th, 2019 | 0 Comments

Manali received a foot of snow overnight two nights ago, and there is prediction of more to come. So keep warm everyone, the snow is finally here!