Today was my fourth day at work in the Emergency Room of Effia Nkwanta Regional Hospital in Ghana. When I get there in the morning at 8:00 a.m. for the day shift there are usually already 20-30 people lined up to be seen. Any true emergencies have been taken care of by the nurses.
I have slowly been gaining the trust of the nursing staff. They see many volunteers rotate through and seem to be a bit leery of someone new at first.
This afternoon we had a mass casualty incident when 35 people from a multi-car pileup all came into the ER at once. It was chaos with lots of broken limbs and lacerations. Also, the patients were all fighting with each other over whose fault the accident was. The ER only has 15 beds and was already full to capacity when the 35 people came in. Patients ended up sitting on the floor, three to a bed, and anywhere else they could find space.
It can be easy to be overwhelmed in a situation like this and the staff at first was focusing on the patients with open extremity fractures; a bone sticking out through the skin is pretty impressive. I systematically but quickly went through all the patients and was able to find one man having severe abdominal pain after hitting his steering wheel (no seatbelts or airbags here). I got the ER physician to see him first and he went directly to the operating theatre for an exploratory surgery. There are no CT scanners here and injured patients are often too bad off to be transported to x-ray, which is 250 steps up a hill. So many patients end up having exploratory surgeries when in other parts of the world, advanced imaging techniques would be used instead.
The rest of my afternoon was spent stitching up various lacerations among the accident victims. Although I’m not happy a large accident like this happened, it did help to solidify my role as one of the “team” in the casualty department.
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