Archaic life support system angers docs
Dr
K K Aggarwal, National President IMA
New Delhi: TOI
report on shortage of ventilators at Delhi government hospitals and use of
manual, handheld devices (also called ambu-bags) to resuscitate patients who
cannot breathe on their own sparked public outrage with many taking to social
networking sites to voice their angst.
The Indian
Medical Association (IMA) and the Delhi Medical Council (DMC) also condemned
the lack of critical care facilities and demanded immediate measures to improve
the scenario. "Use of ambu-bags as replacement for automatic ventilators
is highly condemnable. It should be done away with immediately and government
should buy more ventilators," said Dr K K Aggarwal, National President
Elect -IMA. An ambu-bag is a manual, handheld resuscitation device, which
attendants are asked to keep pressing 16-18 times per minute to move air into
and out of lungs of a patient who cannot breathe on his/her own. Unlike
automatic ventilators, which have controls to monitor, oxygen, carbon dioxide
and other key parameters of a patient, the ambu-bags have no such mechanism. If
the frequency and volume of air pressed through the ambu-bag is high, it can
lead to a sudden increase in blood pressure and damage the lungs. If the
frequency and volume of air is low, it can lead to higher levels of carbon
dioxide, which could be fatal again. Dr Vinay Aggarwal, member of the Medical
Council of India's ethics committee, said that the government must focus on
improving critical facilities in public hospitals. "Putting patients on
ambu-bag when there are no ventilators available is equal to letting them
die," he said. The Federation of Resident Doctor's Association of Delhi
(FORDA) claimed they have raised the issue of lack of critical care facilities,
including ventilators, several times with the Delhi government. "When the
resident doctors went on a strike demanding better facilities in June last
year, state health minister Satyendar Jain sought three months for ventilators,
consumables and drugs. But no action was taken. In May this year, doctors were
assaulted in the ICU of Chacha Nehru Bal Chikitsalaya when they told the
patient's family that bed with ventilator was not available," said Dr
Pankaj Solanki, president, FORDA. He said doctors bear the brunt, and often
assaulted even, for refusing admission due to unavailability of ventilators but
no one questions the authorities responsible for this crisis.
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