Sunday, January 29, 2012

Cutting it close

The cough started the day before, but when he started having trouble breathing, his mom and grandma got a PMV and made their way to Kudjip.  Along the way, his breathing worsened to the point where he couldn’t talk and he was using all his muscles to breathe.  When he got to our ER, our nurses quickly noticed how sick he was and appropriately put him on oxygen, gave him a breathing treatment and called me.

I heard him before I ever saw him and the barky seal cough that greeted me as I was walking into the ER told me this child had croup.  Croup, which causes swelling of the respiratory tract, is a pretty common respiratory illness that affects kids and ranges from mild to very severe, even causing death in a small number of kids.

I knew right away this 5 yo boy had the severe kind and when I looked at his mom, I could see she knew it too.  His breathing was very labored, he didn’t fight my exam, but just laid still, too still in mom’s arms.  If that wasn’t enough to alarm me, the medicine he had been given by the nurse had done nothing to change his condition.  I explained to mom and grandma what was going on with Junior, and then we prayed for this child, that God would  open his lungs and help him breathe.  The nurses worked on getting him an IV and giving him steroids, while I set out to find the medicine he needed – racemic epinephrine.   

I had never seen racemic epinephrine in our pharmacy, but thought that it might be found amongst all the donated meds that we receive from the US each year.  Despite desperate searching, I didn’t find any.  Knowing he needed this medicine, I thought there must be a way to give him the medicine just using epinephrine, which we have lots of.  I finally found a book that told me what I needed to do to make this medicine and then prepared it for him.

I put the medicine in the breathing machine and placed the face mask over his head, all the time praying that this potential life saving medicine would open up his respiratory tract and that God would continue to give him the breathe that he needed.   

While he was breathing in the medicine, I started seeing the other 3 pts who were waiting for me to see them in the ER.  In a relatively short period of time, I realized I no longer heard the seal barking as often as before.  As I glanced at mom from across the room, I saw she also was relaxed and Junior was breathing easier, Praise God. 

I admitted him and checked on him 2 times overnight, making sure he was still doing ok.  What a joyful sight, in the morning, to see him sitting up, talking to his mom and grandma, only coughing briefly.  The following day, he was even better still and we were all Praising God for the breathe of life that He gave to Junior and gives to each of us.