High drama at 30,000ft as girl’s BP dips alarmingly

Nirbhaya Fights On In Singapore Hospital ICU As Govt Fights Another Embarrassment 
Doctors Create Arterial Line To Revive Her Mid-Air

New Delhi: There was nerve-wracking drama at 30,000 feet when Nirbhaya, the 23-year-old Delhi gangrape 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, 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." He added: "Monitoring blood pressure from the arms can sometimes give false readings up to 20mm which could be critical in such a delicate case. Dr Verma is well-versed with hemodynamics (study of blood flow) and is 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 (SST). She underwent a full CT scan and was taken to the ICU. Dr Mishra said that the doctors in Singapore have told him that Nirbhaya's blood pressure is now under control and her condition although critical, was stable. 
TRANSIT BATTLE WON, 
WAR AHEAD 
    Air ambulance, bound for Singapore, takes off from Delhi around 11.30pm 
    Mid-flight, Nirbhaya's BP drops alarmingly 
    At 30,000 feet above ground, doctors create an arterial line—a thin catheter inserted into an artery to monitor BP realtime—and stabilize her BP 
    At Singapore's Mount Elizabeth hospital, 
Nirbhaya's condition turns critical again. 
Her ejection fraction (EF), a measure for determining how well the heart is pumping out blood and for diagnosing heart failure, drops to 25%. 
    Her EF count before leaving was around 50%. The EF reading for a normal heart is around 70% 
    On Wednesday, she suffered a heart attack which could have caused brain damage because doctors could not detect her pulse for nearly three minutes

Members of the team that accompanied Nirbhaya leave Mount Elizabeth hospital on Thursday