Hi all,
As you could guess from the update send this morning,last night was rather more intense than usual. Cite Soleil night team's ranks swelled with 6 new members, yay!! Lots more Canadians, an American, a doc from France, and a doc from London, UK who has been working on the Mercy Ships! Love our international flavour, so much fun. These folk have worked all over the world, and being on a team with them is humbling. And, they have some GREAT stories!!
Recall back a bare week ago when I was going to my first night shift at Cite and I was really anxious, almost sick with it. The new crew had some nerves, but jumped in so well. Cholera numbers still down but we did have a fairly active night in the triage centre. So Triage crew gained another member (I was the only one for a couple nights - eep!) and the doc from Mercy Ships is now the triage doc, double yay!!!! (Ok, now picture groggy medic doing happy dance..... or maybe you shouldn't ha ha ha). Anyway, very pleased to have her join me, there have been times that I have felt like my knowledge and discernment by myself on triage aren't enough. The team docs are very close in the wards, but I am liking this new arrangement!! Wahoo!!
So triage stayed steady enough with patients most of the night, and then sometime around 0300, a 20 year old woman was carried in and deposited on the cot in triage. She lay with her head back, stiff in posture, not moving, and making no sound. Her eyes were open and rolled back. My heart leaped into my throat as I put my hand on her - cold. No radial pulse. And a very difficult to hear apical pulse (listening with a stethoscope). I could almost convince myself I could hear an unsteady beat. Maybe just wishful thinking on my part. I put touriquets on both hands. Nothing. Nothing, NOTHING for veins. The team materialized and suddenly our fantastic peds nurse was on the lookout for a vein, and Dr. Nam (aka Super Nam to Cite Nights) also on the hunt for an elusive vein. Still nothing. Patient not responsive, and search for vein continues. Finally after a couple of nerve wracking tries, one cannula in, just a 22 (small!) but one nonetheless!! Wahoo!!!! Pouring the fluid in as fast as we can. BP cuff serving as a pressure infuser, urging the fluid in faster. Still - not fast enough. The search for another vein continues. A crowd has gathered at the entrance to the IV tent. Everyone knows that life hangs in the balance, here in this moment. A Haitian pastor is here. He prays over her, over all of us trying to make this happen as he helps hold her legs, as she has become combative. Her mom stands with the people. Looking scared, small, and unsure of what is taking place. Still we work, looking at her feet, and anywhere else for another vein. Multiple tries. The girl moans and cries over and over, Mama, why... Mama why..... her mom sat down at the end of her bed and helped hold her daughters legs. Her cries and moans, as heartbreaking as they are, signify hope, she IS responding, thank you God!
Still no success in getting another line, so we opt to wait and allow the one line to do its work and give her the fluid she needs, and hope it is fast enough. We are disheartened to hear an explosive bout of watery diarrhea going into the bucket below her. At least a litre of fluid gone. :( The race continues. We push fluid in, fluid pours out. But, we are winning - I think...... She opens her eyes, and I see that she really is there. While we try another time for a line she cries, and I take her hand. She squeezes. And I squeeze back. Finally, one of the really outstanding Haitian nurses (hey, Brutus!) finds one tiny vein in her poor tortured hand, and in goes line 2!! WAHOO!!!!! We are gonna win this fluid race, and she will have the chance to recover. Thank you God!!!!
All of us pouring sweat in the Haitian night, chilled now. We liberate a tin foil emergency blanket, and tuck it all around our little lady, with wool blankets on top. She had been so cold to the touch, now warm, and alive. Happy dance looked more like slumping down on the cot at her head, touching her cheek, and watching the fluid drip, drop by drop, bringing her back from the brink. A scary, powerful, amazing and real moment.
She received 3 litres of fluid in my care, as ordered, and then we transfered her to the women's ward to receive further care and meds. Her mama told me, Merci. I was very happy to say, You're welcome!
Michelle
Who slept well today. And is feeling privileged to be here.
