High drama at 30,000ft as girl's blood pressure dips alarmingly

NEW DELHI: There was nerve-
wracking drama at 30,000 feet when
Nirbhaya, the 23-year-old Delhi gang
rape survivor , went into a near
collapse in the air ambulance on the
night of Wednesday-Thursday as she
was being ferried on a six-hour flight
to Singapore's Mount Elizabeth
hospital.
Nirbhaya's blood pressure suddenly
dipped alarmingly, and in what is
being considered a medical feat,
critical care specialists Dr P K Verma
of Safdarjung hospital and Yatin
Mehta from Medanta Medicity
created an arterial line to stabilize
her. An arterial line is a thin catheter
inserted into an artery - used mainly in
intensive care - to monitor blood
pressure real-time, rather than by
intermittent measurements.
Explaining the mid-air crisis to TOI, Dr
M C Mishra, chief of AIIMS' trauma
centre said, "We had explained to the
girl's family the potential risks of
transporting her to Singapore. She
could suffer a cardiac arrest or her
blood pressure could fall alarmingly.
After discussions, we took a calculated
risk by creating an arterial line."
Dr Mishra added: "Monitoring blood
pressure from the arms can sometimes
give false readings up to 20 mm which
could be critical in such a delicate
case. Dr Verma is well versed with
hemodynamics (study of blood flow)
and is very well aware of Nirbhaya's
condition while Dr Mehta is highly
experienced. They did a great job."
Nirbhaya was wheeled into Mount
Elizabeth hospital at 9.10am
(Singapore time). She underwent a full
CT scan and was taken to the intensive
care unit. Dr Mishra informed that the
doctors in Singapore have told him
that Nirbhaya's blood pressure is now
under control and her condition
although critical, was stable. Despite
all the complications, her fighting
spirit remains unbowed and she is
bravely battling on.
Dr Kelvin Loh, Mount Elizabeth
Hospital CEO, was less reassuring. He
said in a medical bulletin at 7pm on
Thursday that Nirbhaya's condition
"remains extremely critical". "Before
she was admitted to our hospital she
had undergone three abdominal
surgeries and had a experienced
cardiac arrest in India. A
multidisciplinary team of doctors is
taking care of her and taking all
possible steps to stabilise her
condition," he added.
The team of Indian doctors that
reached Singapore on Thursday
morning also informed that Nirbhaya's
ejection fraction (EF) - an important
measurement in determining how well
your heart is pumping out blood and in
diagnosing and tracking heart failure -
has dropped to 25%. Normal EF is
around 70%.
"When Nirbhaya left yesterday for
Singapore, her EF count was around
50%. On reaching Singapore, her EF
dropped to almost 25% which means
her heart condition has been
deteriorating. A normal heart's
ejection fraction is around 70%," a
source in Safdarjung hospital told TOI.
Doctors also fear serious neurological
damage to Nirbhaya's brain as doctors
could not find her pulse and blood
pressure for nearly three minutes on
Wednesday when she suffered a
cardiac arrest.
"Doctors in Singapore conducted a full
body CT scan on Thursday. They are
also looking at any neurological
damage that could have resulted from
the cardiac arrest. She is under heavy
sedatives," doctors at Safdarjung
hospital said.