Here is a post from one of the other doctors blogs about Vance's first c-section here in Honduras. Since she did such a good job I just posted it here on our blog also (with permission, of course). This actually happened the week before we made our trip to the states.
This week we had our first emergency c-section since our new OB/GYN, Dr. Vance Pirkle, arrived. A women arrived in clinic with low amniotic fluid levels and was 2 weeks past due. She was induced knowing it was about a 50/50 chance she may need a c-section. She progressed well throughout the day until she started pushing. The baby was almost out when it just didn't move anymore and using suction didn't help. The baby didn't like the suction and it's heart rate started to drop prompting us to rush her to the OR. I made a quick call on the radio for some extra help from John (our NP/midwife) and Penny (a nurse and nursing educator), everything went smoothly. Within a few minutes we had a baby! Mom and baby both did well. The mom had a small lower uterine tear from having to remove a baby from so low in the uterus but it was easily repaired.
Our usual missionary who does anesthesia is in the States for 2 months so I was the one running the anesthesia for the surgery. Being new to the OR and unfamiliar with all that was in it, I wasn't keen on doing general anesthesia and having to breath for the patient during the surgery. The patient weighed near 300lbs and I was a little worried about a difficult intubation too. Dr. Vance had a few years of experience as a missionary doctor in Africa prior to coming here and has done over 100 c-sections with a drug called Ketamine. I was very familiar with Ketamine from residency (thanks Dr. Omori) and so with a little fentanyl and a stiff dose of Ketamine we were in business. Next c-section, I hope that it's not nearly as rushed and maybe we'll have a little time to do spinal anesthesia.
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| Penny as baby nurse. |
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| Dr. Vance and NP/midwife John |
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| Dr. Vance with his first delivery here at Hospital Loma de Luz. |
