Tuesday, February 13, 2007

Soothing spa bath

In my last week of Obstetrics, I encountered something quite odd, dumb, and funny at the same time. We had this one patient who was being hospitalized for eclampsia (seizures, hypertension, and proteinuria during pregnancy). She was currently receiving magnesium sulfate, which is the standard prophylatic treatment for eclamptic seizures, and required hourly "mag checks" to ensure she was within normal therapeutic range, as elevated Mg levels can cause some potentially serious toxic effects. And since there was a shortage of inpatient room, this patient stayed in one of the delivery rooms which had the necessary facilities for performing natural water births.

Being a student on the OB wards, this is where I come in, eager and happy to be assigned the task of performing hourly "mag checks." On my first bedside visit, I noticed that steam was coming from the pateint's bathroom and that there was someone in there actively in the process of filling up the tub with hot water. Because the patient said that it was her boyfriend, I didnt think too much about it, and instead proceeded on with my history taking and physical assessment. Two minutes into my pulmonary exam, I hear the faint ring of alarms going off, and had I not had my sthethescope on at the time, I might have heard the beeps coming from the same bathroom, signaling to everyone at the nurses station that there was an emergency in my room. Within seconds, three resident nurses hustle in and turn towards me, seeking an explanation and some direction for action. I look up in calm, take off my sthethescope, and offer back only a puzzled look of confusion, unaware of their sense of urgency and worry.

It turns out that the patient's boyfriend was soaking in the tub, and had purposely pushed the emergency alarm button so that he could get some assistance with turning on the jets to the tub. This made me laugh. Who was this guy, and what made him think he was staying at the Hilton? Did he not realize that the facilities were meant to be for the patients only, and not to be confused with a full service spa and jacuzzi? Did he not realize that the tub he was just soaking naked in was actually a tub used by obstetricians to perform waterbirths in? That it was a contanier for laboring mothers to sit in and bathe within a mixture of warm water, blood, feces and amniotic fluid. Gross and well deserved. I hope he found it refreshing.

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