Welcome to the ICU here at Dhaka Medical. It was an interesting morning. Here's a brief run down of what I observed and learned:
-there are twenty beds and they are always full
-there's no method of performing dialysis at the bedside
-bronchoscopy (camera to look into the lungs) has to be done in the OT(operating theatre=operating room), there's no mobile cart (transport of critically ill patients can be dangerous)
-guillan-barre syndrome is a common diagnosis, it's too costly to administer some of the disease modifying agents (IV immunoglobulin or plasma exchange) and physical rehab is hard to come by, it's done by family members
-the arterial blood gas(sample of blood from an artery which quickly is analyzed and gives levels of oxygen and carbon dioxode among other things) analyzers are non functional throughout the majority of the year
-the portable cxr machine is available, the films are hard to read bc they are still old school films and sometimes the cassettes (to capture the film) run out
-the monitors are often missing parts
-there are ventilators and they DO work...
The need for further training in ventilator management along with how best to utilize the resources that do exist is low lying fruit. It is a whole other thing to just provide missing resources without a plan for sustainability. How to balance this issue is what strikes me as one of the biggest challenges.
*all images were taken with permission of staff and surrounding family
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