Monday, February 7, 2011

Friday afternoon on Call

Call can be a few phone calls and some verbal orders, multiple trips to the ER to evaluate pts, multiple C-Sections or OB complications or anything in between.  This past Friday, I was on call with Dr. Al, a retired FP and a 1st time volunteer missionary here with us for the month.  We sent everyone else home from outpatient area at 2pm as there was no one else waiting to be seen.  I walked to OB to make sure things were quiet before I left and then walked into the ER, where I had been only a few moments earlier and found 3 new pts who had arrived, some pretty sick.  I called Al back to the ER and along with our ER nurse and Al's wife, we started working through the pts who were there and then those who kept coming.

- 20 yo lady who is very pale due to pelvic bleeding after missing a period - concerned about ectopic pregnancy, but ended up being a miscarriage - needs admitted, IVF, blood and a D&C when stable.
- 30 yo with fever for a month, no identifiable etiology, do US, CXR, an LP to rule out meningitis, get labs, start Abx and admit
- 40 yo with HTN and HA thought secondary to sinusitis - treated and sent home
- a 1 yo with a prolapsed rectum from diarrhea that we pushed back and gave medicine to
- a 40 yo lady with wrist pain for 1 month - treated and sent home
- a guy with blood all over his face and a scalp laceration due to a fight - sutured and sent home
- a 16 yo who fainted, but has nml vital signs - waited until all others left, admitted for malaria
- a 20 yo who was chopped, same fight as above - opposite sides, nearly amputated his ankle with the chop along with other chop injuries - needs IVF, stat blood work, blood for transfusion, surgery consult, prepare for OR, security needed to prevent any fighting between the enemy lains
- young mom just delivered a week ago with F and abdominal pain - US, IV, Abx and admit
- elderly lady who was beaten by her family after a small child died complains of abd pain, no BP - US reveals free fluid - likely a ruptured spleen - IV, stat blood work, find the ambulance/security to transfer to Hagen for ER surgery as we only have 1 OR and were just getting going on our ankle amputee guy
- 40 yo with fever, body pain started today - treated and sent home

It has obviously been a while since I have been on call, and my ones thus far have been quiet.  This was by far the busiest 5 hrs, I have had in a while.  Hopefully, we didn't scare Al too much.