Email from Haiti Relief Team 01.29.10

EMAIL FROM DR. STEPHEN BURGHER 01.29.10

Well, long and crazy day.

I went to work at HCH hospital today. Randy and Heather went to some camps and churches today. I'll have to let them tell their day separately as we have only briefly talked and I remain at the hospital working night shift.

Lots of patients today. Still seeing injuries untreated from the earthquake (e.g. femur fracture, distal humerus fracture, complex pelvis fracture) all getting by for 15-16 days but needing surgery. Also, lots of medical illnesses like pneumonia, TB, vomiting/ diarrhea illness, uncontrolled hypertension, atrial fibrillation, etc. But the best was a motor vehicle collision, pick-up truck rollover with 3 young men ejected from the back. The injured guy had a blood pressure of 85/palp, heart rate of 110, head injury with combativeness, tender left chest with decreased breath sounds, tender right abdomen, bloody urine when catheter placed. After establishing an IV and improving his blood pressure and heart rate, we then walked him by military stretched to X-ray (exact other side of hospital). All I could get was a chest and pelvis X-ray. His left chest was full of blood (hemorhorax). We took him to ICU and placed a tube in his chest with a significant amount of blood return. Subsequent CXR showed the stomach and nasogastric tube to be in the left chest with high left diaphragm, which means he ruptured his diaphragm and implies significant blunt force trauma and high likelihood of other internal injuries. But he remained stabilized until we were able to ship him by helicopter to the US Comfort about 8 hours later, where he'll undergo exploratory surgery, as well as better testing (CT) for his head injury. The other 2 were more stable but nonetheless banged up enough to watch them over night. In the meantime, now on the night shift, I've been dealing with a woman in labor, a woman with severe abdominal pain, an 89 year old with pneumonia and severe sepsis (systemic infection).

We had a patient die tonight in the ICU. She was actually admitted to the ICU 3 days ago by me for severe pneumonia. We prayed with the son, who has been at her side the whole time. Shortly thereafter the 9 month pregnant woman came in in labor. Death and life. There is so much of both here. That is the image I have of Haiti.

That's all for now. Need go on medication rounds.