Wednesday and early Thursday in Damoh
Wednesday looked to be a typical long day until out last case, a four year-old from the wait list for a palatoplasty. Surgery went well and the field looked dry at the conclusion, but he was bled in PACU. His airway was problematic so we took him back to surgery for examination. There was a bleeder in the floor of the nose. The field was arid extra dry at the end and I extubated him deep to avoid coughing. He didn't tolerate extubation so I intubated him again, suctioned blood from his trachea twice, gave him naloxone (a drug that reverses the effects of narcotics) and gave him another shot at extubation. This time he flew, but for safety's sake we kept him in PACU overnight. Three of us stayed over: one of the nurses, one of our pediatricians and me. He looked great after about three am. The three of us went back to the orphanage for breakfast and a nap.
The rest of Thursday
I floated for the early part of the afternoon and did one case, a soft palate repair on a 1.5 year old. She had reportedly been fasting for four days, so I tried jot start an IV before surgery. THIS DID NOT INTEREST HER in the least. After three tries by two people I decide to give us all a break and wait until she was asleep. That made it easy and the rest of the case went smoothly. Back to the orphanage by 21:00. The van for the airport leaves at 5:30.
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