Usain Bean Bolt

After my lengthy spell of absence due to Christmas, Birthdays and Weddings I am back. And better. (You probably realise I am not writing this, but my friend has hijacked my computer.) She also is holding me to ransom and demands an Apple Mac. (Two in fact so I can have one.)

Helen's plea: "Help".

Please don't listen to my friend Rosie, she is a bean and therefore has a very wild imagination. I am able to write now while she washes up our mugs and sings to herself. Apparently I am mental as I tied a knot with my tea bag around the handle of my mug :( I thought that this was a perfectly sensible thing for a tea drinker to do. (Normally I drink coffee which doesn't come in tea bags, unless of course you have found these miraculous coffee bags, but then they are coffee bags and not tea. Think on it, it makes sense.) Now I get a kitten, apparently.
We have acquired five cats, four of which are tabbies but one is a very adorable black cat that may soon be finding its way into the house; except that the dog gets jealous. The dog is much cuter. An far more adorable. The dog has FPS (favoured pet status)

But enough of that for now. I am currently having a week off while my friend is here but I have left A and E (where I worked for 4 months) and have moved to Gastroenterology, but I shall tell you more later!
Byeee

18/10/11 - 19/10/11- 20/10/11 and 21/10/11

After the excitement of Monday the next few days were relatively quite. I did some more sutures with one of the doctors who was trained as a surgeon and inserted more catheters and IVs. Luckily there were no major emergencies so all in all it was a relatively quiet few days.

17/10/11 - Truck man

On Monday I inserted my first IV into someone just before a man was carried into the Emergency Room on a stretcher. Apparently he had fallen from the cab of his lorry whilst going around the corner at full speed. Unfortunately no one knew about any other conditions he might have had before he fell, however he presented with high blood pressure and when the doctors roused him he confirmed that he had 'pressure' so he was give two sprays of nitrates under his tongue. Moments later he had crashed and the doctors started CPR immediately taking turns. He was intubated so that his trachea remained open and one of the doctors controlled his breathing; he was given a total of three shots of adrenaline and his heart had stopped beating for nineteen minutes before it finally started again. Throughout the CPR his oxygen saturation had been fine (98% or above) but as different specialists from other areas came down to ER his saturation levels started to drop. I was put in charge of controlling his air bag and ensuring that he continued to receive as much oxygen as possible. His stats continued to drop over the next hour and the surgeon announced that he thought the man had a haemopneumothorax which is where blood starts to collapse the lung. He inserted a chest tube which should help to release the pressure on the lung and re-inflate it. Although the man still wasn't stabilized he was sent to ICU where he was then sent to surgery. A few days later we found out that he had survived. 
Later that day I performed my first sutures including one over the eye and a very wide cut on a young boys leg.

13/10/11 and 14/10/11

On Thursday I joined the UWI interns for a suturing lesson and learnt about continuous and discontinuous stitching as well as the different types of thread used. Hopefully I will be able to do some sutures of my own soon!
On Friday I spent the morning with the nurses in triage which is where the patients are first assessed; the nurses take blood pressure, glucose and urine tests as well as a brief history of the complaint. Depending on the seriousness of their stats and complaint depends on whether they are seen by the triage doctor, sent straight to the ER or sent home. I tested the blood sugar of several of the patients until a call from ER came through recalling all doctors and nurses back to ER as there had been a bus crash and all the injured persons were coming to the hospital. Back in the ER I was given a pen and paper and followed one of the nurses around as she gave some of the wounded a painkiller and I took down their names for the records later. As it turned out most of the injured where walking wounded - only one, a pregnant woman, was hurt badly enough to be admitted.

11/10/11 and 12/10/11

On Tuesday I was shown how to insert a urethral catheter into a man's penis then was allowed to perform the same procedure myself! That is my very first patient! Apparently the hospital have many men come in with enlarge prostates who have catheters which get blocked; as their bladders get distended this is considered an emergency so they get seen quickly in ER.
On the Wednesday there was a young boy who came in as a transfer from the University of the West Indies Hospital (UWIH). The boy had been knocked of his bike at midnight the day before but because he didn't have health insurance he had to be transferred to KPH. When he arrived the boy was in a bad state; unconscious but still able to breathe on his own, he had a compressed cranial fracture and there was blood putting pressure on his brain. The consultants or senior residents from general surgery and neurology came down to see the boy and his injuries, however while they were down there the boy went into cardiac failure. CPR was started and an air bag was put over the boys mouth so that his breathing could be controlled by one of the doctors or nurses. After two shots of adrenaline and seven minutes of CPR the boy's heart started to beat again and he began to breathe. The boy was later taken to the surgery ward so that the pressure could be relieved from his brain and his broken leg set.

10/10/11 - Second day in the ER

The start of my first proper day in ER was very exciting with an elderly woman coming in from a car crash and needed both her lower legs amputated! After that things slowed down a bit as I was given a more extensive tour of the ER. I watched the Drs perform several procedures before I was shown around the complicated filing system! There is no computer based system in Jamaica instead each patient is given an ID number according to when they first turned up at the hospital then each individual file is stored in one of two rooms. That sounds easy enough but the problem is that many of the files are missing or incomplete. Some even have the wrong name!

07/10/11 - ER

In the morning I met up with Nicki and went to wait for the SMO only to find out that both he and his secretary were on holiday. We were ready to go home very disappointed when Dr Wong told us to come and see him in ER. Feeling sure he would tell me it was impossible for me to work in the ER we went to see him and after a very short conversation he said, 'sure you can start now.' We stood staring at each other for a moment then Dr Wong introduced me to a young lady named Dr Reid who would look after me then he disappeared and a very happy Nicki went back home.
Dr Reid looked a little at a loss for what to do with me but at that moment a young man came in who had been stabbed in the hand and back. Dr Reid told me to come and watch while they ultrasounded his heart to see if the knife had punctured it. Luckily it hadn't but the man was making so much noise you would have thought he was dying, however once he was told he was fine and would be going to have an x-ray he stopped screaming and started playing on his phone! Later on an 18year old girl came in with a stab wound in her side, she was 5 months pregnant with her second baby and she was very scared. The doctor and the nurses spent most of the time dealing with her minor wounds singing and dancing around her. The Doctors and nurses were all really nice and didn't seem to mind me being there at all. I left about 2 o'clock and couldn't wait to go back Monday.
It was my housemate's birthday today so we went with her to one of hr workmates houses and had an amazing jamaican dinner and a wonderful chocolate mousse cake. Yummy!