Thursday, 31 May 2012

BEFORE YOU DRINK YOURSELF INTO A DITCH…

How I have missed the blogosphere. The things I have been through lately in the medical realm have been immensely preoccupying. If the persistent haunt of incoming examinations severely obliterating the posterior sphincters of my intelligence, physiology and anatomy (in that order) are anything to go by, my day lasts at least eighteen hours. Oh, add my ward rotations to that. That leaves six hours for social life and other activities. Paradoxically enough, sometimes I feel like I have overslept when I wake up before the alarm clock. I think I need to see my Shaman.

Talking of alarm clocks, lately, I hardly even use mine. Thanks to the numerous sirens, courtesy of living in the vicinity of two major hospitals and right next to a major road, I can wake up any time other than the designated time. Here is how the situation plays out; I fall asleep after a tiring day. Next thing I know, Siren! Siren! SIREN! First thought: maybe it’s a VIP (Very Idiotic Person) maneuvering their way to be on time for a breakfast that’s on my tax or, an ambulance transporting unauthorized morons or contraband to some location. Either way, this calls for Plan A:

 *Gets out of bed, calmly screws the silencer onto the muzzle of his Dragunov and pivots it on the window sill before aiming and squeezing the trigger, sending a single round flying in the cold morning air and watching it sharply connect with the siren- obliterating it on impact. Silence*

Take that you Banshee.

But then again, it may be an ambulance desperate to reach the A&E before the victim inside gives up in which case Plan B comes into play:

*Sinks deeper into bed covering his head with a pillow hoping its sound proofing qualities suffice the current scenario*

Not a very good idea, but at least I gave the victim a fighting chance. I can live with that. I resign to dragging myself to the freezing shower. I’ll skip all the uninteresting details until the part where I walk into the hospital gate [slow motion effects] clothes neatly pressed, groomed as per protocol, tie tethering my thyroid, stethoscope and all in place… Then a weaver bird flies by and offloads on me the products of what I later diagnosed as a transient constipation… [Remove slow motion.] Needless to say, my ‘matrix’ skills are not word worthy. I hold on to the idea that being shelled on by avians is considered a blessing by some tribes to keep up with my so far crappy day.

Later, when a few accomplices and I are at the A&E looking to learn a thing or two about clinical practice, a stretcher comes in. Guy on board: an Unknown African Male in stupor smelling of urine, the mud stains on him suggestive of a night of one-too-many ending in an unpremeditated swim in some ditch. After some shaking he finally wakes up with the ‘I’m-I-in-heaven?’ look in his face. A few cheeky questions follow all to establish his state in the time, space and person orientation. At least he remembered that he was over-indulging and that his ‘friends’ are all turds for letting him go home on his own. We can work with that.

First thing to do: fluid therapy. After efforts that almost culminated in us calling a bouncer, the guy calmed down so we could set a drip. Amidst all that, we had brushed off some of our English into his wasted brain and he kept yelling ‘What’s up!’ then staring at us like a retarded goblin. He was then wheeled out to recuperate.

Another U.A.M. is wheeled in and his stretcher parked right next to where we are standing. Other than being schizophrenic, this fellow was either too sleepy or had also partaken of the bottle, the latter more likely. Simple math: ‘The-crazies + Alcohol = Comedy. No?’ *Slaps knee* ‘As you were.’ He pointed at us and said that we had colluded with his wife to steal his land, his beloved goat and his wife while he was asleep. For these charges, he condemned us to a HIV infection, a sentence that would be in effect starting the next week. *Gavel-knock* Case closed.

We try not to laugh as we leave for lunch break. Hardly three paces on, we see Mr. Alcohol, blood dripping from his forearm as he stares at it blankly. He had ripped off the drip that we’d taken forever to fix. When he notices our presence, he stares at us and shouts ‘What’s up!’, then smiles sheepishly. *In my mind* [thick Irish accent] ‘Waiting for a round applause ey?’… We quickly patch him up, recommend close monitoring and walk away. As it all sinks in, I remember a sticker I saw someplace: ‘If you must drink and drive, drink milk.’ My take; if you must drink and take yourself home, at least drink something that won’t make you 'confuse' some culvert for your bed. In related news, any one up for a glass milk?

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Monday, 28 May 2012

ON BLASTS AND SAFETY



Dear Kenyan,

I am blogging this on behalf of those more honorable before me and my colleagues helping out at the Kenyatta National Hospital Accident and Emergency department right now. For the three years I have been in medical school, I have come to realize that there is nothing as gruesome to the eye as the sight of human suffering. Health professionals never get used to seeing casualties and the loss of human life. Safety cannot be overemphasized. By the look of things, we are living in perilous times. The year has hardly hit its half mark and several have lost their lives in the unacceptably high number of explosions and terror attacks that have since occurred. Many others have been maimed loosing the ability to live a normal life.

It is unfortunate however, that authorities both local and otherwise seem to be lax on this matter. Many Kenyans are also seemingly unwilling to learn lessons that could help them live another day or help their afflicted colleagues better cope with such unexpected situations. Most of these things can however be avoided by proper enlightenment of the greater population and, by individual and collective responsibility. I take this opportunity therefore to emphasize a few important measures that could help you, esteemed citizen, survive or help out in the event you find yourself in such a situation.

Be vigilant. Scan your environment and ensure that all volatile or explosive utilities are kept in designated areas far from meddlers and other potential triggers. Ensure all faulty sockets and bare wires are repaired. After using cooking gas, ensure that the taps are well closed. Keep an eye out for suspicious looking people when in crowded places.
When the unexpected happens, don’t panic. Act fast and decisively. Find cover, preferably a sturdy non flammable structure. If you can find none, get down: your head between your knees using your hands to cover your head. Do the latter as close to a corner as possible. In case it’s a grenade attack, do it with your head away from the grenade. This will minimize your exposed surface area and keep you safe from any projectiles that come with the blast.

Usually, two waves emanate from blasts; a shock wave and a thermal wave. The latter leaves those around confused and sometimes concussed. Internal bleeding can also occur. Thermal waves can cause burns of varying degrees including inhalational ones. These effects are supplementary to those caused by falling debris and projectiles secondary to the blast.

After a blast, try and re-orientate yourself to assess whether you are trapped or not. Perform a quick self-assessment for any injuries then call for help. If you are ambulant, try and clear from the site as fast as possible. If you are a passer-by, steer clear of the scene. Avoid the temptation to help, collect your property or even loot. Your life, health and safety are worth a lot more. If you must help, do so when you are sure that the worst has passed. Preferably though, let the professionals handle the aftermath. There is always the possibility of a secondary explosion soon after the first.

In case you are called upon to assist, try and stay calm. Knowing that the victims need immediate attention is necessary but being calm and collected while doing can help avert secondary injuries. In transporting the injured to the paramedics, stability of the head neck and spine is vital. A neck brace can be modified from soft cloth as padding with carton paper as reinforcement. If a stretcher is not available, carry the casualties using a hard board or a folded blanket to keep the whole body level. Don’t rush. As mentioned earlier, let the paramedics handle the rest.  

In summary, stay vigilant. When it happens, stay calm, act fast, help if you must and be safe. Lastly, be your brother’s keeper; pass this information to everyone you know.

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