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Post by spinifex on May 10, 2018 19:32:07 GMT 10
This is one I've pondered a number of times since both my kids arrived by C-section.
Ebola has mutated with Influenza to become a much more contagious disease. It retains its current 50% mortality rate. The disease has been in the population where you live for several weeks and is likely taking a heavy toll. You retreated early to a farm in a rural setting (Lucky you!) and set up a successful quarantine. You are a small family group and one member of the group is a registered nurse (Lucky you!). Your only medical supplies are typical household contents, a detailed medical/surgical manual and a decent first aid kit to the standard typically carried in vehicles by remote area workers or coastal yachties. (ie no painkillers or antibiotics). There is a fully equipped hospital in the nearest town - population pre-ebola 3000.
You have an adult daughter (mid 20's) who has gone into labour at full term. It is her first baby. After 24 hours of labour the nurse in your group and other adult women who have had kids agree something has gone very wrong. A natural birth seems impossible. The consensus is she will die without a caesarian operation to remove the baby which is believed to already have died due to complication.
What do you do? Attempt the operation yourself? (The nurse in your group will assist but will not attempt the operation) Watch her die? Break your quarantine? Something else?
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tomatoes
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Post by tomatoes on May 10, 2018 19:50:31 GMT 10
Too late now, but one thing to do if you go into quarantine and have a member of your group who is pregnant would be to spend significant time seeking out a doctor or even a vet who you might be able to call upon. Perhaps offer something (well before the birth) in return? I’m not sure how you’d find someone if they aren’t already part of your group though.
I will admit that with a nurse in the group I may feel that I had it all covered and not be looking for another medical person. If childbirth is imminent though, it should be a priority.
Assuming that has been impossible, I have no idea what I’d do.
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dingo
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Post by dingo on May 10, 2018 21:47:04 GMT 10
If you have been present at one before and have a text book, some stored YouTube videos I think you would attempt the cesarian yourself. She is already weak from Labour so you don't have time for much else by the sounds of it.
Set up as clean a space as possible and git'er done.
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dingo
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Post by dingo on May 10, 2018 21:53:41 GMT 10
That is one way.
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bce1
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Post by bce1 on May 11, 2018 19:49:16 GMT 10
We discuss that in our book - www.ausprep.org/manualsIt’s a risk benefit issue. It is certainly possible. There is also a relatively simple procedure called a sympthectomy - which is the dividing of the pubic bone joint - it allows the pelvis to open another 3-4 cms and potentially for the baby to be delivered. It is safer than a c/section with a semi-skilled operator - but isn’t a perfect option either. Gross bit follows - only read on if a relatively strong stomach.... X X X x XX X X X X X X X X X X X X X X X X X X X X X X X The other option is to do a destructive procedure on the baby. It is much more simple than a c/section - it is life saving for the Mum, but obviously deadly for the baby. It is regularly done in the third world. There are a variety of approaches and it does depend on exactly what is wrong with the labour and the position of the baby But ultimately it involves collapsing the babies skull or decapitating the baby. In a truely Austere situation this is perhaps the safest option but it involves the death or the baby.
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Morgo
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Post by Morgo on May 12, 2018 15:30:08 GMT 10
I would be scouting the nearby town and hospital to assess the situation and whether or not its an option to take her there (are there even any doctors left?) or if I can get supplies/equipment needed from the hospital for the operation.
I don't like the chances of performing the operation. I think you would have to be extremely lucky for it to be successful and that's only if there are no other issues.
A friend recently had a C Section, there were issues. Fortunately both mum and bub are fine but with out a doctor to recognize the issues and correct them both likely would have died.
So while the operation you perform may be a success at first there could be other issues you can't see or fix resulting in mum surviving the OP only to die a short time later.
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feralemma
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Post by feralemma on May 13, 2018 12:05:25 GMT 10
We discuss that in our book - www.ausprep.org/manualsIt’s a risk benefit issue. It is certainly possible. There is also a relatively simple procedure called a sympthectomy - which is the dividing of the pubic bone joint - it allows the pelvis to open another 3-4 cms and potentially for the baby to be delivered. It is safer than a c/section with a semi-skilled operator - but isn’t a perfect option either. Gross bit follows - only read on if a relatively strong stomach.... X X X x XX X X X X X X X X X X X X X X X X X X X X X X X The other option is to do a destructive procedure on the baby. It is much more simple than a c/section - it is life saving for the Mum, but obviously deadly for the baby. It is regularly done in the third world. There are a variety of approaches and it does depend on exactly what is wrong with the labour and the position of the baby But ultimately it involves collapsing the babies skull or decapitating the baby. In a truely Austere situation this is perhaps the safest option but it involves the death or the baby. It hasn't been mentioned wether the nurse has done an internal to determine exactly what the problem is. There could be a few things stopping the labour from progressing, including non-dilation of the cervix and mis-presentation of the baby. If it's a mis presentation then something can be done to correct it and maybe help guide the baby out. I'm not sure if there are natural ways of helping dilation along, but they'd be worth looking into. A c-section would be the only option if dilation can't be progressed, in which case a shitload of spirits consumed very quickly by the mum would help get her thru it and relax her. Collapsing the babies skull would help only if the cervix was dilated enough to permit the baby thru (tho a torn cervix from forcibly removing the baby this way would probably heal a little better than a c section under those conditions). Cutting the baby into pieces probably wouldn't help as you'd still have to try and remove those pieces or the mother would die very quickly from sepsis. Under no circumstances would you want to breach your quarantine and put the rest of your group and family at risk, especially for someone who has a good chance of dying anyway.
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Post by jonasparker on May 14, 2018 1:10:49 GMT 10
I'm an old paramedic and former surgical tech. I've got the books and the instruments. If my daughter and her husband agreed, I'd go for it!
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Post by spinifex on May 19, 2018 12:59:47 GMT 10
We discuss that in our book - www.ausprep.org/manualsIt’s a risk benefit issue. It is certainly possible. There is also a relatively simple procedure called a sympthectomy - which is the dividing of the pubic bone joint - it allows the pelvis to open another 3-4 cms and potentially for the baby to be delivered. It is safer than a c/section with a semi-skilled operator - but isn’t a perfect option either. Gross bit follows - only read on if a relatively strong stomach.... The other option is to do a destructive procedure on the baby. It is much more simple than a c/section - it is life saving for the Mum, but obviously deadly for the baby. It is regularly done in the third world. That's Heavy. But thanks for sharing. Well ... the consensus was the baby is probably already dead. This is one of those moments when you realise how third-worlders are seriously robust people who will likely one day inherit the earth. What seems major SHTF for us is 'situation normal' for them.
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Post by spinifex on May 19, 2018 13:05:32 GMT 10
I would be scouting the nearby town and hospital to assess the situation and whether or not its an option to take her there (are there even any doctors left?) or if I can get supplies/equipment needed from the hospital for the operation. I was initially thinking along these lines too.
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