Friday: Last day in the OR and a fruitful one!

After a week that seems to have been both long and short at times the last two cases are entering the ORs. It has been a pleasantly productive day with both ORs at our disposal, with a brief gynae case in room 1 in the morning for the local team. 6 cases today the final tally.

If there was a theme today it was neglect. First case was a skin graft to the abdomen. The unfortunate patient had suffered a perforated diverticulum which was left until it formed an enterocutaneous fistula. Not the sort of pathology you see in Canada, but people here can be very stoical about their health issues

The abdomen was successfully covered and we handed the reins to the gynaecologists. In room 2 a tibia was nailed followed by another challenging case. 

This is the left knee of a 31 year old farmer. He was walking on this for 8 months!! His leg on that side had telescoped 4 inches shorter. Unfortunately a functional knee was not possible and it had to be disimpacted and fused, stable but still shorter.

The redoubtable Taylor mans the C-Arm

Last case in room 2 a k-wire of an elbow. Plastics/Ortho joint exercise: Marti scrubbed in to help, another example of the good team work which has characterised this mission.

Next door in 1 the recently comatose diabetic patient with a gangrenous foot has finally agreed to an amputation! Anaemic and still haemodynamically precarious an interesting end to our clinical time here!

 

Some examples of the random chaos of the anaesthesia supplies. Drugs are of various origins and vintages. Supply boxes usually have what it says on the outside, but again in various size and state of repair. A word to the wise is to have located everything you could possibly need for your case beforenyou start because you will surely be unable to locate it in time of crisis! My surgical colleagues have found similar issues with instrument sets etc, almost none of which seem to be fully stocked. 

I discovered also it was simple things like syringes and catheter mounts that were in short supply, for the surgeons towels and C-Arm covers.

I would say things are much better than before and the OR runs as smoothly as possible under the leadership of Miss Michelle Barjon, who rules with a rod of iron and a heart of gold. There is however a need for better inventory control, in fact any kind of inventory, which would help in pre-mission planning and would save a lot of time exploring cupboards and shelves on arrival.

Meanwhile today has seen some unrest on the streets of Port au prince and we have heard police helicopters all day. Hopefully there will be no rioting to keep us from team dinner tonight!!

Hope to have an entry with pictures and stories from elsewhere in the hospital up in the next day or two. So if any of my readers on the team can oblige please do so!

Ok last patient dropped off, narcotics returned to pharmacy and I am in my shorts relaxing. Tomorrow we will be Nova Scotia bound with lots of stories and memories!