I spent my third day in the casualty department at Effia Nkwanta Regional Hospital (ENRH) today. We were especially busy today as the outpatient female department was closed, so all females who needed even non-urgent treatment needed to come through the Emergency Room.
When I arrived at 8:00 a.m., the queue was around 30 people, some of whom had been waiting since 4:00 a.m. There are 3-4 nursing students in the department each shift , and I was able to instruct the students on blood drawing today and all of them successfully completed their first blood draws on patients.
One specific case that stands out from today is that of a 5-year-old boy named Samuel. He was transferred to ENRH from an outlying clinic. He had been walking alone along the road to school and was hit by a car at a high rate of speed. By the time he got to us, it had been around three hours since the accident. He had severe head trauma. ENRH does not have a CT scanner but we were able to take x-rays of his skull and face. He was found to have several open skull fractures as well as multiple open fractures of his jaw. While he was in the ER, Samuel’s mental status continued to deteriorate, indicating likely bleeding and swelling in his brain. The only hope for him would be to get him to Accra where the few neurosurgeons in the country are located. That is a 4-5 hour drive by car and he did not have that long. Unfortunately, the only helicopter medevac service in the country is operated by the military and not available for use by the general population.
Sadly, the only thing we could do for little Samuel was to admit him to the pediatric ward where his family could spend his remaining time at his side. It is heartbreaking to see cases like this, knowing what needs to be done, but not having the equipment or resources needed to do it. Would immediate intervention have saved Samuel’s life? I don’t know. My only comfort is in knowing that his last moments were with his family.
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