Thicker skin- Bara trauma unit

So day 2,  yet again I made my way on the roads to Sowetto and got lost again in the Township!

Once arrived into Resus trauma:

23yrd old PVA v motorbike. GCS 2/10 intubated, severe facial fractures and epistaxis with posterior packing foley catheter and anterior packing,  # pelvis. Head injury- SAH, DAI, no brain stem reflexes. 18 hours later it was decided turn the vent off and for T piece as neuro surgical final review..  basically TLC. As he was initially an unknown male the family couldn’t be contacted…. they finally arrived 23 hours later 17.00hrs… they were so distraught. Possible organ donation.

Other resus patients trauma assault- gross facial swelling, tubed. Another unknown male. Various other trauma patients- minor area busy with patients we would put into resus.

The trauma resus are managed well by the team- Primary A-E, secondary survey, C spine immobilised, airway stabilsed +/- tube/vent, IV/I, fast scan, ABG, catheter, NG, tetanus, IVAB, analgesia.... next patient

Trauma round in the afternoon to the ward and ICU- the ward is full of sick trauma patients post surgery or intervention, all MVAs and assaults…. These are severe assaults from the community or individuals. The community might of shunned the patient for a wrong doing then they beat them, the police arrive and stop the killing… sometimes if they make it. I have only seen the ones that make it. The violence is serious and high…..

One white man (only the 2^rd I have seen in either off the hospitals)… GSW into Right orbital area the bullet lodge into C2…. The bullet not to be removed- memorial piece of shrapnel!! Now week later worsening condition and confusion… to monitor.

                                                                                                  

Back to trauma and helped tubed a patient with polytrauma that had been transferred. The trauma surgeons and medical officers carry out the airway and tubing, including difficult airways then refer.

The surgical intervention and skills are impressive, the doctors run the units and work so hard..

Getting to know who’s who- who to work with and how to communicate or ask for things to be done… dialogue… hello… pause…. How are you… pause.. wait for an answer … then ask for want you need really nicely!!  

What an experience… we are so lucky for what we have in the 1^st world