A night in the ER

Do I hear a siren... Or a car alarm? I think I saw the reflection of an ambulance’s red lights? Or maybe it was just a trick of the light? I don't think I've ever looked out for an ambulance so keenly as last night. And so that began my first night shift at the HVM ER. 

And what a night it was! There were nurses decked out in perfect white trying to put pressure over hemorrhaging wounds (how much bleach must they need here?!), doctors dashing out to the pharmacy to grab necessary supplies, and patients being wheeled in and out to open up spaces in the ER. The LATE students definitely knew what they were talking about when they said that traumas on weekend nights would pick up. 

Unfortunately for us however, all of the patients were arriving via taxis and cars (another question in of itself! Why are patients choosing not to call the FREE ambulances to get to the hospital??) It's hard to study an EMS system without the EMTs! We were able to collect more data but just not quite the sample size we were hoping for. Collecting enough samples is going to be harder than expected, but every research project comes with its hiccups.

On the other hand, in terms of a medical experience, it was incredible. It was awesome to get a chance to observe an Ecuadorean ER in full swing. It was a mix of the old and the new. It was the same policies that I was familiar with in the US, just with slight twists adapted to the hospital. In Ecuador, there is free healthcare for everyone. There are public hospitals and private hospitals. HVM is a public hospital, and it has limited resources. According to Sandro, our LATE host, at HVM, you just learn to work with what you have, whether that be a shortage of hydrogen peroxide, dull sutures, or simply not enough space.

Last night, I got to follow a patient from the start. He arrived on a backboard with the EMTs. With a Glasgow score of ten, he wasn't very responsive but still flinched to pain and tried to fight off the pulse ox. As the doctors rushed to find a room, it was touching to watch the EMTs stay with him. Despite the country, EMTs play the same role of patient stabilization and patient comfort. I watched as an EMT touch his hand, to try and reassure him.  After the transfer, we followed him to imaging (CT, X-ray, and ultrasound). Everything that we had learned about in class, now in action! Sagittal views, Coronal views, transverse views. An X-ray to check for hip fractures, a huge source of bleeding. Ultrasound, to check his internal organs.