Health Partner

A terrifying case which reminds us why Emergency Rooms of hospitals should be equipped to handle the most complex of trauma cases.

A miracle in the ER He came in with a rod through his head but he left alive
Monday, July 23, 2018 - 14:39

 

It is difficult for Mohammed Tarique to comprehend what he should be doing, be disappointed with destiny for his near-fatal road accident or thank his doctors for his miraculous recovery. He is grateful that he is alive, but the terrifying road accident has left him shaken. In the wee hours of April 28, he was rolled into the Emergency Room (ER) at the Apollo Gleneagles Hospitals Kolkata with an iron rod through his head. The rod entered his forehead, went through his skull, and protruded from the back of his head.

It was a scary sight. The 24-year-old was rushed into the ER after a long ordeal for the firefighters, who cut the iron rod from the road-divider it was attached to and sent him to the hospital. The staff at Apollo were shocked and surprised – he was alive in spite of such a severe injury. They swung into action immediately.

“The most important thing to do was anaesthetise and manage his vitals. After he was stabilized, I was given a call. He was on a ventilator when I arrived,” recounts Dr. Binod Kumar Singhania, Consultant Neuro Surgeon, Apollo Gleneagles Hospitals Kolkata, who led Tarique down the path of recovery.

However, the placement of the iron rod made every step of the procedure a challenge. “The question was how to do the CT Scan with such a big rod in his head. So, we took him to the Oncology building where the machine is bigger. We tilted the machine and used it, but the scan was not very informative due to the metal.” Time was ticking, and Dr. Singhania had to take a call. He decided to take him to the operating table immediately.

The major challenge was to remove the rod and do so without too much bleeding. “If we remove it carelessly, then the brain will bleed profusely,” Dr. Singhania explains. The surgical team took to some innovative thinking and decided the endoscope was the best tool for the procedure.

“We used an endoscope and pulled the rod out slowly, and then we stopped the bleeding at the points in the brain where there was damage,” he says.

Explaining the procedure further, the doctor says, “The endoscope is a minimally invasive instrument. We could not open the skull. So, we followed the rod as it was pulled out and did the surgery through the endoscope. Under high magnification, we used haemostatic agents to stop the bleeding. We were also equipped to deal with any major vessel bleeding, but fortunately we did not face that situation.”

After this delicate procedure, another CT scan was done, which found that there was no major bleeding, and the patient was then wheeled into the ICU. Twenty-nine days later, Tarique stepped out of the hospital alive. He did suffer some brain injury, but with therapy, he could live a normal life.

Azizul Haque, Tarique’s cousin who has been taking care of him along with his parents says, “When he got to the hospital he was bleeding profusely and was unconscious. Honestly, we had no hope of getting him back. But the doctors here acted likeGod and with their sincere effort we have got him back.”

Not entirely a miracle

While even doctors tend to see this as a miracle, doctors at Apollo Hospitals point out that such cases are a result of the high standard of medical services and strong processes put in place by their emergency department.

“Our paramedics are well trained. We only employ registered nurses, who have 4 years training, into our emergency departments, and we also train them further. All the staff have Advanced Trauma License,” says Dr. Singhania.  

Over the years, Apollo has not just become quicker at the ER, but also put in place new practices which are years ahead of many other hospitals across the world. “We have reduced the Door-to-CT Scan time, so that we can immediately identify the problem and its complexity and start the treatment. We also have better processes,” says a doctor from the Emergency Department.

Dr. BK Singhania

For instance, Apollo does not give IV fluids to trauma patients who have lost a lot of blood in the accident. “What is the point? If somebody has lost a lot of blood, giving bags of IV fluid is detrimental. We have to give blood, even today many hospitals don’t do that,” he says.

But would a blood test not take too much time? How do they know which blood group to give at that moment?

“True, we don’t have time to do a full blood test, so whatever the blood group of the person is, we immediately start them on O-ve blood. But O-ve is very rare, so if we don’t have it, we give O+ve. It is not a perfect option, but it is not problematic in most cases, so it is a calculated risk,” he says.

It is methods and processes such as these which have ensured the high quality of medical care at the emergency departments of Apollo across the country, he says.

There are also lessons for all of us here. “People should not attempt to remove any rod or foreign object themselves after a road accident,” Dr. Singhania warns, “that could cause more damage and we cannot save the patient.” The patient must be immediately taken to the nearest hospital where the staff have the skill to handle such complex trauma cases, he adds.

This article is a part of a partnership series between The News Minute and Apollo Hospitals to bring you latest medical developments and inspiring stories. The article was produced by TNM Marquee in association with Apollo Hospitals.