Night in Gaza by Mads Gilbert

Author:Mads Gilbert
Language: eng
Format: epub
Publisher: Skyscraper Publications
Published: 2015-03-15T00:00:00+00:00

The anaesthesia gives him some rest for a short while.

The little boy is terrified. We must anaesthetise him.

‘We should anaesthetise them both to secure their airways and control the pain,’ I say to my colleague, in a slightly enquiring tone.

‘Agreed,’ he answers briefly.

We rush breathlessly into the small intensive burns unit, with its three beds. It seems the staff knew that we were coming, as two of the beds look ready. An intensive care doctor and three nurses help us. We greet each other briefly, and they point us to the beds. Greeting people is important. It is part of the basic decorum that helps us to normalise our behaviour in chaotic situations like these. We always shake hands, as long as it is practical, and establish eye contact with each other. This time we cannot shake hands because our hands are literally full, but we nod to each other. It makes us a stronger team. Respect, courtesy and human warmth are important, and they help now too, as we try to keep up our spirits.

The boy’s screams are anguished and piercing. I lay him down gently on the large bed. The white quilt cover looks newly washed. At the head of the bed is a mint-green piece of cotton, of the sort we use in operating theatres. In more affluent parts of the world, we almost exclusively use packed, single-use, sterile bed sheets made from medical paper. As a result of seven years behind the Israeli blockade, there are shortages of everything at al-Shifa, even single-use sheets. They make do with their own simple solutions. A colourful bath towel lies folded on top, acting as a small pillow.

‘I’ll intubate him now. Can you help me?’ The nurse nods. The little boy’s screams are noticeably raspier now. I am worried that his burns might also have reached his pharynx and airway. The swelling around his eyes has expanded over the course of just a few minutes. Interstitial fluid is leaking out of his cells and blood vessels; the cell walls have been damaged by the explosion and the heat, and are no longer able to retain fluid. The boy’s increasingly hoarse screams are caused by his pain and fear, but they also suggest that his vocal cords have been burnt.

When we intubate a patient, we pass a sterile and relatively stiff plastic tube through their mouth or nostrils and through their oral cavity. Then, guided by sight, the tube is passed below the epiglottis, down through the upper parts of the windpipe and past the vocal cords, stopping before the windpipe divides into the two main bronchi. This procedure requires a special instrument to lift the tongue and the epiglottis, a laryngoscope, and it is so uncomfortable that it cannot be performed on a conscious patient without first administering a general anaesthetic, or by applying local anaesthesia to the mucous membranes.

Time is of the essence now. The boy’s airway must be secured, so he will need a general anaesthetic.

I grab

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