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.