Week 2
Johannesburg – 22
nd Nov 11.
After some interesting further days in
Cape Town, I head back again to
Johannesburg. The flight was entertaining I do meet an array of friendly and innovate people on my travels, here people actual talk to you therefore your encounters are opportunistic.
Arriving in JHB severe storms and lightening, rain does tend to follow me. Returning to JHB a second time I felt more confident and less apprehensive compared to my first visit with trepidation- familiarity breeds contempt.
This weeks my days consisted of pre-hospital response car on the roads of JHB, how I’ve missed bombing around the roads at 180kmph while experienced paramedic J is on 2 mobile phones and the radio weaving around heavy traffic who frankly do not move.
The days consisted of Motor Vehicle Accidents (MVA) and Pedestrian Vehicle Accidents (PVA), assaults, anaphylaxis’s, medical conditions, collapses. Last MVA P1 off one of the days- entrapment in vehicle side been taken straight off, severe head injury and deep laceration anterior to posterior scalp, humeral and ? femur #, ? pelvis.
Only in Africa the tow trucks get to the accidents quicker than the
EMS as they get paid to inform the companies and tow. It’s a confusing system but sometimes all EMS respond the private companies and government then depending on the patient and care needed either with ALS paramedic or ILS crew will go to the most appropriate hospital with the patient, but other days lone ALS responder attends just depends on how busy the city is. Patient today allergic reaction was unwell enough to go to a private hospital but did not have medical aid… however she was not sick enough for the government hospital…
Hilarious vision this am on a blue call to a incident- lights on and sirens driving fast on the slip road
as rush hour when some cheeky guy was following behind just to get through the traffic… so stopped the response car asked him what he thought he was doing in return he shrugged his shoulders then proceeded to get into the normal flow of traffic…
Africa!
And so the days continue with picking up guns visiting the police station and many more pre-hospital calls. More MVAs, some P4 which in
South Africa’s triage system is dead rather than in the
UK it means lower priority and can wait for up to 2 hours.
Shame no Bara shift but that means I have to come back even earlier now- addictive Bara trauma unit needing that resus room and wanting to help those people...
Friday night 3.30am call- shooting with suspects still actively shooting. Location rural farm other side of town. Male, gun shot chest entrance and large exit wound probably shot through posteriorly and shots x 2 bilateral femur. Lung parenchyma seeping through gun shot wound on the right chest, transmediastinal GS wound with trajectory, on auscultation fluid, bubbling sounds throughout chest. GCS 14/15, sats 90% o/a, 15 L 02 sats 92-94%, 90/54 p122, 2L hartmans insitu. With sounds of further shooting in the back ground, call for police assistance and the heli ordered. On arrival of the heli the road was closed and the patient eventually got air lifted.
We went to Jburg Gen the next evening to find out the outcome- patient went to theatre we think but we had some information he was waiting for CT chest report? Anyway he was on a high care ward- not ITU. That’s incredible- these folks are robust and do not die easily!
