Now thats what I call trauma!

The first day anywhere is like the first day of school- not sure whether the kids will like you and who will nick your sandwiches, doctor's friend works in Groote Schuur Hospital (GSH) and while he changed into his theatre scrubs some porter had nicked his trousers which he had to wrestle with to get back- love Africa!

So made my way on the busy rush hour roads of Cape Town to Tygberg Hospital negotiating the motor ways, as I have no AC I tend to turn to up like Princess Perspiration as the intense driving speeds heightens my level of sweating… nice!

Finally found the Hospital and University large old grand buildings where I met Senior Lecturer of Critical Care Janet Bell who has been invaluable in organising this trip. The University was amazing, robust academic institution with the best skills lab, moulage rooms, sim suite even a laryngoscope sim suite. Janet was hugely passionate about nursing in SA and what makes a good nurse- she was enlightening and refreshing and I learnt a lot about SA academic nursing. However this University of Stellenbosch- is one of the best academic institutions in SA so this comparison does not necessary reflect a true picture across SA, students are very lucky to attend here.

Then after lunch back on the highways jeez the Capetonians drive fast weaving out of lanes, I prefer to cruise at this stage being a virgin on the SA roads!
In a inch of my life I arrived at GSH and here I met Matron Patton, small powerful lady who runs the trauma and emergency unit at GSH, so friendly she introduced me to everyone and called all the head nurses and professors. I was showed around the unit which holds Trauma and Emergency on either side,

Emergency has resus, HDU and MAU, gynae unit, full psychiatric unit, DSU, infectious disease unit and triage. On the trauma unit side resus with Lodox a full body x-ray machine, CT room , theatre, trauma area. Patients with chest drains ICD sit in chairs then onto exercise bikes to get them out quicker! And huge helipad with a view of Cape Town stretching the harbour and beyond.

Nurses on shift… 9 in each of Emergency and Trauma.. 9!!! Say no more to nurses  reading this!

I got pretty much stuck into trauma resus- synopsis only here!:

First patient:
Gun Shot Wound GSW from gang shootings to the right chest -entrance wound T6 exit T8, haemothorax and pneumothorax, acute abdomen probably liver laceration. ICD inserted by paramedics.

Second patient:
GSW gang shootings to the head entrance and exit wound, GCS 5, racoon eyes, blood from nose then eventually after an hour of being with us… brain was oozing out of the nose and blood pouring from both wounds in the head. He was herniating- hypertensive and brady. So decided to do apnoea tests and depending on ABGs for harvesting his organs… only if the relatives arrived for consent otherwise just to die.

Third:
14 yr old girl GSW to the neck- caught in 2 gangs gun fire.

The nursing and medical teams primary surveys were slick and the team worked well. Some of the equipment was not great, but the skills outstanding. No more medical jargon or the details here but I had an amazing first day, loved every minute of it. The staff were all so friendly and welcoming which I had not really expected from what I was warned. Huge high! Now that’s what I have come to learn! Looking forward to tomorrow’s shift. :-0