Dr. Vanda Abi Raad, Clinical Professor, Director of the LAU Clinical Simulation Center, and Assistant Dean for Continuing Medical Education
We had to go back to basics.
A good number of nurse-anesthesiologists and residents were gradually arriving at the scene that night. So, we were well staffed as a team, but had only three anesthesiologists. The other anesthesiologists could not join because they were quarantined for COVID-19 or because their homes were destroyed and/or family members were wounded. As we opened more and more units to patients, we had to spread out across floors. With no specific anesthesiologist in charge, we worked together – physicians, residents and nurses – to close the loop in crisis response management.
One case that stuck with me was that of a patient who had skull fractures and was bleeding heavily. He required a CT scan of the brain and was on the radiology floor, so I had no access to the advanced equipment for intubation. We usually use an endoscope to guide us as we insert the tube, but the heavy bleeding made the video useless, so I had to do a blind intubation. We even had to hold up the tube manually during his scan. The context was so difficult that no matter how advanced your skills are as an anesthesiologist, you are forced to deal with a situation where you have to go back to basics. I’m thankful that we were successful, that the patient went on to surgery, stabilized and recovered.
As anesthesiologists, our comfort zone is our operating rooms, but we had to get creative and use whatever we had at hand. I received a young boy who was unstable and had to be intubated, but we couldn’t afford to lose precious time finding an empty bed, so we placed him on a medical trolley, intubated him right there and then, and then moved him on this trolley to the radiology department.
Walking back home between the smashed cars, fallen facades, and shattered glass, I felt so much anger, rage and pain. Then dawn came slowly, and with it the miracle of a new day.