Interesting Day

I was just finishing up my lunch trying to figure out what I was going to do with a 2o- something kid who was complaining about his sternum painfully "popping in and out"and had a normal chest xray, when there was an overhead announcement in the hospital of a level 3 (as opposed to level 1 or 2 which are more critical) trauma with several patients. This didn't quite phase me as I wasn't too worried about a level 3. Then I get summoned from one of my techs saying everyone is needed in the ER for the traumas.

If any of you follow the news or at least try to follow the international news, you might have heard about the avalanche in Afghanistan. So far on CNN, it is reported that 60 were killed after being trapped in the Salang tunnel in the Hindu Kush mountains. We received a lot of the survivors. I have no idea of the numbers. I think at one point I heard 180 people. Most of these, however, did not end up as patients in our hospital, but rather people who just needed a place to warm up and lay their head for the night. There were not actually very many "traumas" either. In fact about 30+ people waited in the steamy trauma bay for 2-3 hours waiting for these patients that eventually trickled in. I waited my 2 1/2 hrs in the trauma bay before I went back to our clinic to start seeing some minimally injured patients. Seeing patients through an interpreter is always interesting as is muddling through the culture differences. I first saw a family of 4 from 4 months to 11 yrs dressed partly in traditional Afghani clothing with added western-style overcoats and shoes. All actually pretty healthy with maybe a cough or runny nose, but nothing bad. I haven't treated a kid in over 7 weeks - it was nice to hold a baby again. I also listened to lungs through a burka - not the greatest exam, but she's still breathing. She also had a headache so she got a Toradol shot in the arm, but she wasn't allowed to show bare arms in front of the interpreter. One of the more interesting cases was that of some frostbite. It was my first experience with frostbite. We had to cut this Afghani's wedding ring off. I felt horrible. His hands actually didn't look that bad; they were fairly swollen and red. I just don't know what they will look like tomorrow or the next day. Will he get blisters? Will he develop necrosis (dead tissue)? Will the tips of his fingers turn black and autoamputate? I won't have a way to follow up with this guy, but he was thankful to get some tingling sensation back in his feet with clean dry socks and shoes. And the last most interesting patient who I actually didn't assess, but was told about first because, as my tech said, was covered in gasoline. WHAT? There is a guy covered in gasoline in our waiting room? Um, does this not sound good to anyone else? I go up to our window to find this rather plump Afghani male in traditional (loose fitting) clothing standing there. My first few thoughts included, oh dear, is going to set himself on fire or does he have a bomb hidden under his clothing? Come to find out that he only wreaked of gasoline because he'd been trying to fix his car that had stopped running in the snow. Nonetheless, he got a shower and changed into our beautiful blue scrubs before he was seen by my colleague.

Strange day and I'm going to bed. There might be more tomorrow.