The difficult decisions

Sometimes medicine is not easy, especially in the developing world. I abhor determining who should receive a limited resource and who should go without.

This week I was faced with a difficult challenge. Two infants needed oxygen therapy and we only had one machine available. One of the patients was born extremely sick, with profound oxygen desaturation and appeared to be septic. Another had pneumonia and low oxygen levels but was otherwise stable.

This is just one example, but the situation arises fairly frequently. Should we give the resource to the most ill patient and give them the best chance at survival? Should we treat the moderately sick patient and nearly guarantee success? Or, should we split the resource between the two and risk inadequate therapy and a negative outcome for both.

This week, I choose to give the septic child the oxygen. Fortunately, they both survived this time.

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