On August 11th, 2021, a 27-year-old pregnant patient brought to the Community Health Centre (CHC) Kaza, was diagnosed with Abruptio Placentae. A caesarean section had to be performed on the very same day for delivering the baby. The patient encountered persistent vaginal bleeding, a post-surgical complication that needed specialist consultation for clinical management. Apollo TeleHealth has been delivering technology-enabled specialist healthcare services to the rural communities in and around Kaza, for over six years. A teleconsultation with Dr. Alpa Khakhar (MD, MBBS (OB/GYN) an experienced (20 years) Urogynaecologist was arranged on an emergency basis from Apollo Hospitals Chennai. After a detailed evaluation of patient’s medical history and clinical assessment of the patient’s condition, Dr. Alpa diagnosed the patient as a case of post-partum haemorrhage. She advised medicines and clinical procedures to control bleeding and recommended a blood transfusion. This timely intervention helped in stabilizing the patient. She further advised to closely monitor the patient and transfer her to a higher healthcare centre for further care.
Meanwhile, the baby started developing complications as the delivery was preterm and the baby was born with low body weight. The baby had bluish discolouration at birth, for which Cardio Pulmonary Resuscitation (CPR) was performed followed by other emergency clinical procedures. Post stabilization, the baby was shifted to the neonatal care unit. However, the baby continued to exhibit low blood sugar levels. A teleconsultation with Senior Paediatrician Dr. Latha Vishwanathan (MBBS, DCH, DNB (Paediatrics) (22 years of experience), was organized on an emergency basis. The Paediatrician obtained details and advised to administer IV fluids and NG (nasogastric) feeding. She further advised the staff to monitor oxygen saturation, Random Blood Sugar (RBS) levels, and bodyweight of the baby, regularly. Apollo TeleHealth staff worked with Government staff in monitoring the baby round the clock and ensured oxygen administration based on the saturation levels.
The mother and the baby had to be monitored for 4 days round the clock, owing to the difficulty in arranging for transport and tough terrain. On the 6th day, the baby’s blood sugar levels dropped dramatically to 31 mg/dl. A teleconsultation with Dr. Latha was again arranged at 10:00 PM on an emergency basis. The Paediatrician recommended to transfer the baby to a higher healthcare center for further care and advised to continuously monitor Random Blood Sugar and Oxygen Saturation. In addition, the mother started developing pedal oedema. Therefore, both mother and baby were shifted to Mission Hospital in Manali. As the condition of the baby was critical, the BMO of Kaza requested Apollo’s staff to accompany the baby. Apollo’s staff nurse Ms. Tanzin and one telehealth coordinator accompanied the mother and the baby.
Throughout the arduous journey, Apollo’s staff continuously monitored the baby’s saturation and blood sugar levels, and vitals. During the journey, an instance of difficulty in breathing for the baby was efficiently handled by Apollo’s staff using an Ambu bag. Fluids were administered to the baby, as advised by the Paediatrician. The capability of Apollo’s staff combined with the remote specialist guidance ensured safe transfer of the baby to a higher healthcare facility. After reaching Mission Hospital Manali, Apollo’s staff detailed the doctor and admitted the mother and the baby. Apollo’s staff followed up with the mother and the child on the next day. Both mother and child were found to be stable and were being monitored by Mission Hospital staff. Expressing her gratitude towards the efforts and commitment of the entire Apollo TeleHealth team who worked for 4 days 24X7 to keep the child alive, the mother thanked the entire staff for ensuring their safety by providing tender loving care.
About Himachal Pradesh Telehealth Services Programme
Kaza is a remote location in the State of Himachal Pradesh, located at an altitude of 12,000 feet. Apollo TeleHealth has been providing specialty, super specialty, and 24/7 emergency stabilization care in Kaza since 2015. Apollo has been playing a critical role in delivering quality, reliable and timely care to the remotely located communities and contributing towards the futuristic vision of Govt. of Himachal Pradesh.
