Day 2

So let me start by introducing my team members:

Torrey - ED physician
Britney - nurse on transplant stepdown unit
Dave - internal medicine physician
Lynn - nurse on OB/neonatal unit
Loren - internal medicine physician
Betsy - nurse on med/surg floor
Evan - physical medicine and rehab physician
Flo - colorectal surgical nurse
John - pharmacist
Me - PA

I joined the team working the day shift today. Our first patient was actually a Canadian gentleman who has a laceration on his heel. Since I have not done sutures in while, Torrey got it ready for me and then I finished it off. By the time I finished there was an older woman waiting for what I thought was a dressing change. This lady had been in a motorcycle accident resulting in a leg injury 5 years ago. When I went to remove the gauze dressing, I quickly realized that this dressing was adhered to her wound and likely had not been changed for quite a while. The wound was necrotic and pussy. She was in a lot of pain and will most definitely need an irrigation and debridement of that wound. I suspect she also had osteomyelitis. We gave her two shots of ceftriaxone (since this seems to be the antibiotic in best supply) before her family would then transfer her to Doctors without Borders where she could be seen by orthopedics.

The next patient was a 10-year-old boy with a scrotal laceration. I believe he was climbing a tree. I assisted Torrey in suturing this. This kiddo was stoic. When the wound was getting numbed up, he had tears streaming down his face, he cried out a couple of times, but he did not move at all. It was incredible, there is no way a kid from the US would have reacted like that. I just hope he comes back to get those sutures out.

The last patient I helped out with was a young women who had some type of accident with a mirror. She had a huge laceration over her knee, one on her shin and one just below her buttock; all on the left side. Based on x-rays and a brief wound exploration we are fairly certain that she cut her patellar tendon. I sewed up the shin and buttock lac and we sent her to ortho to look at the knee.

At this point, when I say we transferred this patient...I mean that they were loaded onto the back of a truck.

Meanwhile, there were several patients being treated for a variety of issues in the ER/ICU area. This includes stroke, head injuries, EPS reaction (including seizures) to neuroleptics, intracranial bleeds. There was one gentleman who had been hit by a car. He had vomit all over him when he came in. When he finally got a CT it showed a massive brain bleed; there is nothing else we could do for him.

So apparently here in Haiti, the family members do the majority of patient cares. They bring in food and water for the patient. They also provide sheets and clothing for the patient. So if the patient does not have family there, they do not get any further cares besides an IV and meds. Therefore, Flo, Britney and I worked on getting these patients cleaned up.

The interpreters are a lot of fun. All of them are young men in their 20s and they are really good at what they do. I think they can do some medical care too, if needed. I am dazzling them with my pathetic attempts at speaking francais. It's a lot of fun! They speak back to me in creole and although there are some words I don't understand...I can typically get the gist of what there are saying.

Well, since I'm borrowing John's computer, I should call it a night.

Until tomorrow....