A Key Clinical Message:
- It is rightly said that prevention is better than cure. Given the
extreme difficulty in management of conjoined twin along with risk to
two lives, it’s even truer. The general public should be made aware
for such group of patients and to make them follow covid appropriate
behavior. Vaccination to be given on priority basis to these subsets.
- A more robust approach of telemedicine consultation is required for
management of patients in remote areas at the time of pandemic.
- Intubation was also a challenge in our case. There must be difficult
airway cart at hand before intubation. Ultrasound guided central line
placement should be the norm. Prone positioning is difficult in such
patients. An alternative to this should be turning both the patients
in toto around. But practically this is difficult and requires a lot
of manpower. Ventilator management of these patients is still
intriguing. We failed to maintain oxygen saturation with volume
control mode and a high airway pressure. We changed the mode to
pressure control mode targeting improved oxygen saturation. However,
it was still very challenging to ventilate.