A High-risk Ambulance Transfer and Management of a Critically-ill Patient with Severe Acute Pancreatitis in Oman
Dr Ashik Sainu Mohiyadeen – Sr Consultant Gastroenterologist.
Dr Dilip Abdul Khadar – Specialist physician (Intensivist). Aster Al Raffah Hospital, Muscat, Oman.
Mr. H, a 30 year old gentleman had complaints of severe abdominal pain and was admitted to Ministry Hospital, Nizwa. He was admitted at MOH there with Severe acute pancreatitis and was subsequently intubated and mechanically ventilated since the day of admission due to haemodynamic instability, MODS. He was managed there on ventilator for a whole week.
He was found to have severe hypertriglyceridemia. He was also an alcoholic. His CT done there has features of severe necrotizing pancreatitis.
Our Gastroenterology team was approached by his family to take over the case since he was deteriorating and after deciding to take over the case our Aster hospital team went to undertake this high risk in ambulance to Aster Al Raffah Hospital, Muscat for further care.
On arrival at the hospital of transfer, the ICU patient was on ventilator SIMV mode, sedated with Midazolam, Fentanyl and Propofol. On high dose Iontrope support with Dopamine at 15 mcg/kg bodywt/min on flow, barely maintaining a systolic BP of 90/50, tachycardic with a heart rate of over 140/min.
His output was maintained with 40mg IV
