Dr. Krzysztof Pujdak criticized the proceedings regarding the tragedy described by him. He wrote that the presence of a specialist in the ward does not guarantee proper care if the doctor cannot perform or assess a basic abdominal ultrasound, and the hospital does not have an effective way to obtain the examination urgently. He described the translation that the ultrasound was not performed due to the lack of a radiologist as a manifestation of faulty organization, and the lack of these skills and capabilities as compromising. Pujdak also referred to the explanation that there was no pediatric surgery department, so no help could be provided. He stated that the absence of such a department does not exempt one from recognizing the threat, initiating treatment, and organizing assistance. He also accused pediatricians of a too-narrow diagnostic approach and pointed out that differential diagnosis should have considered, among other things, bowel obstruction and basic surgical causes. He noted that diagnosing hyperglycemia does not require — as he put it — "diagnostic virtuosity." As an example of efficient action, he described a model that, as he wrote, could function in Germany: the emergency department doctor begins the diagnosis, and when he cannot perform or interpret the ultrasound himself, he calls a prepared colleague, e.g., a pediatrician or general surgeon. He added that outside of standard working hours, between 5:00 PM and 7:30 AM, such a doctor could be on call and come to the hospital. After further examinations, a decision should be made about surgery on-site if the appropriate conditions and competencies are available or about the immediate transfer of the child to the appropriate center. According to Pujdak, bowel obstruction can be operated on by any county hospital that has surgery and anesthesiology. Pujdak wrote that mistakes occur in every system, including the one he works in. However, he deemed the explanations that one could not help due to the lack of a radiologist, department, or appropriate specialization as shocking. #zdrowie #medycyna #chirurgia (translated)
