More Trauma and Drama

Last night just before dinner Sheila came and told us that they were requesting a "muzungu consult" at the hospital for a trauma patient. Apparently it is a cultural thing that doctors will not listen to nurse's regarding clinical decisions so as you can immagine we were all very surprized by this.

Naomi and I went down to the hospital to find an 18 year old boy who had been hit by a bus. He had a very badly fractured left arm with multiple rib fractures on his left side accompanied by deminished lung sounds. I'm not an expert at reading x-rays but I think he also had a small pneumothorax. The physicians wanted to transfer to him to Butari for surgery consult. They were asking us if we thought this would be safe and advisable or if we should keep the patient at Kibogora.

He was too unstable to transfer in the "ambulance" with no oxygen for 3 hours, a potentially expanding pneumothorax, and unstable rib fractures on a "road" that is more like a dry river bed. So... Long story short we prayed hard and admitted him to the ICU. I wrote a "nursing care plan" (ICU orders in reality) and wrote a very thorough note in English. I checked on him again during the night and agian in the morning. He has been stable! I'm not sure how he will do long term as there are a million possible complications but I'm confident that the decision to keep in Kibogora was the right thing to do and the ICU nurse did a fantastic job of caring for him.