Psych Ward?

It was VERY extremely slow this morning in casualty. I couldn’t believe how dead it was compared to yesterday, not to mention it’s CASUALTY. Isn’t the emergency room almost always packed?? It was so boring! We did rounds with the doctors first thing, and that was nothing too exciting. They were pretty much figuring out which section of the hospital to send all of the patients off to from the previous day. Since there is such limited space in casualty, the turnover is very quick. Each patient can usually be put in another part of the hospital anyhow. It got a little more exiting later in the day. First of all, we got news from our internship friends (UCT final year of med school students) working in the casualty ward with us that the gunshot wound to the hip patient who was in resus when we first arrived had died on the operating table. We also found out that the guy with pneumonia stopped breathing and passed away without waking up and being able to say goodbye to his wife. That was kind of a sad start to things, and I felt quite down. I don’t like things like this!! A woman was suddenly rushed into resus later that day with a massive MI, or heart attack. It was pretty cool because all three of us got to assist the doctors with everything .We cut all of her clothes off, got an ultrasound machine to see her stomach and chest, put an IV in her neck (central line) to give her medication immediately, placed a catheter in, and tubed her. Putting an IV in the neck isn’t the most pleasant thing to see or experience I’m sure. The needle, which is very long and quite thick, has to be placed into the huge arterial vein on the side of the neck. To make sure it goes in the right place, somebody has to use the ultrasound machine to locate it while the needle is being shoved in by another doctor. The needle is attached to a tube a little bit larger in thickness than the needle itself. Once the needle is quite deep within the vein, the doctor has to take a blade and make an incision in the neck just below the needle so that the tube can be slid in to take the place of the needle. The needle is then slid out, and the tube is left in the vein. This is done when they need medication to take quicker effect in the body. In this case, it is able to travel straight from the arterial vein to the heart, which is very quick. When an IV is placed in the hand or arm, it goes into smaller veins, and has to travel a further distance. Before we were able to tube her, she stopped breathing, and the doctors and interns took turns giving her CPR to get her heart started again. It only took three minutes, which was fortunate, because the longer it takes, the more likely it is that she will be left with permanent brain damage. She was finally stabilized and thought to be okay.

During all of this, quite a few psychosis patients were checked in. It sounded like a psych ward in there. But, we were kept in resus so we didn’t get to see any of them for long. A man came in with a stab wound to his abdomen. We didn’t see much of this, as it was time for us to leave; Uncle is very punctual and doesn’t like when we are late hehe. He is the cutest.