Saturday, May 16, 2015

I won't be doing this when I get back to work in the USA

This afternoon after teaching all morning, I was puttering around at Alumni House when one of the Haitian Doctors knocked at the door. She said that a patient with spinal cord injury had just arrived at the hospital and she needed a cervical collar. She had called Sabine, the acting Haitian Director of PT (regular Director is off at a Conference in Canada), who is in Port au Prince this weekend. Sabine told her that I had a key to the Physical Therapy Department where the cervical collars are stored. (There really isn't a security force here with a set of master keys, so keeping track of keys can be a challenge.) I jumped into a pair of scrub pants (we are asked to wear slacks rather than shorts inside the hospital as a sign of respect) and headed out the door. The Doctor and I unlocked the PT Department and pulled down the box of donated cervical collars. We fished around and found 3 styles that looked like they might fit the patient. Unfortunately, none of the 3 are really intended for the type of rigid immobilization that is needed at this early stage post injury. But they were what was available. We took them to the waiting area at the front of the hospital where the patient lay very still on a treatment table. We carefully placed the collar. The Doctor asked me to help move the patient off the table by the door on to a rolling cart that would be his bed. The cart was bare metal; no mattress. I told her that this would not work; this paralyzed patient would be in immediate danger of skin breakdown. I thought I had seen some extra cart mattresses piled in an inner courtyard, so I left to try to find one. I found several carts in better condition than the one intended for the patient--in such good condition that I strongly suspected these were the ones reserved for surgery. So I went back to the overnight ward where I had seen one cart piled high with 3 pads. I took the top one. Now a Haitian family member doing this might have been questioned. But an older 'blan' (foreign) woman doing this was overlooked. The pad was too wide for the cart, but we used it anyway with one side rail left down and the mattress extending over the edge (refer to previous blog about safety posts for how acceptable this would have been in the USA). We slid the patient over to his bed. He appears to be completely paralyzed. Time will tell if this injury is permanent, but life for this man is likely forever changed . . . .

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