ON Dec 27, 2007, Benazir Bhutto lost her life in a gruesome incident.

According to the 'Blue Book', a fully equipped ambulance is positioned at Number 3 behind the VVIP vehicle and the Professor of Surgery (Grade 21 Officer) is in charge of the medical team in the ambulance.

In case of panic and chaos, first aid and emergency treatment is to be provided at the scene of the incident by the ambulance staff. The first aid includes

1. Insertion of intra-venus canula for fast infusion.

2. Clearance of airways.

3. Pressure dressing of wound to minimise blood loss.

4. Instubation for life support; only then is the injured person shifted to the nearest tertiary health-care facility.

Nothing of the sort happened in Benazir's case. The ambulance was nowhere to be seen in TV visuals.

When the critically-injured Benazir reached hospital, she was almost dead. The surgeon in charge at the hospital could have easily checked the 'viability' and pulse oximeter which instantly flashes the pulse rate, blood pressure, respiratory rate and oxygen concentration in blood.

Cardio pulmonary resuscitation (CPR) rarely entails thoracotomy (opening up the chest) and manual compression of the heart to revive the critically-injured subject as was done in this high-profile case to which President Zardari erroneously referred to as post-mortem.

Lastly, Benazir sustained comminuted fracture, involving temoro pariental region of the skull from which brain matter protruded and ruptured the middle moningeal artery which bled her to death.

M. HANIF AWAN
Chief Surgeon
Mirpurkhas