It was pretty busy night shift in the ER today.
The first patient that came in was complaining of pain in her eye
after having cement flung in it. The doctor checked out her eye and rinsed it with plain NSS. He sent her home and told her to come back the following morning to get it rechecked and referred to the city if necessary.
The next patient came in after having vomited ten times in one day accompanied with dizziness. After the doctor talked with the patient, we leaned that he had already been diagnosed with chronic hypertension and was already prescribed maintenance medication for it. The doctor didn't know for sure what was the cause but had a hunch that it might have to do with his dosage so he had him admitted and put under observation.
We also had an unusual MVA case. The patient came in walking under his own power but was bleeding from the head and upper and lower extremities due to scrapes from the accident. However, the patient was very drunk and refused care by physically making himself inaccessible to the nursing staff. It was a difficult situation because the nursing staff can't exactly hold him against his will, but if he signs a wavier that states he refused care, they can let him go. He was so drunk though, that he couldn't figure out how to sign his name on the release form. Luckily, his friends were with him and they convinced him to stay until his parents showed up and signed the papers. While he was there the doctor and nurses did their best to assess his condition and told me it appeared he suffered only minor scrapes and would most likely be alright.
Our second admission was a 6 month old baby with a cough persisting for 4 days. The doctor hooked her to an IV line and ordered ampicillin via IVTT after the nurse confirmed a negative allergic reaction to the medication.
Finally, the last patient of the night came in with a fever persisting for 2 days and rashes all over the body (which has been one of the ways the flue has manifested itself this year in this region of Cebu). The doctor told the parents to monitor him over night and bring him back tomorrow for a CBC and UA to confirm a prognosis of season flue.
On a totally medically unrelated note, I drove a scooter for the first time today! Here in Dalaguete (and everyone in the Philippines) motorcycles and scooters are the main type of personal transportation. After our last ER patient, the night was quiet so one of the nurses told me to try riding his scooter. That's another strange thing I've noticed about the ER -- all the patients seem to come in groups. The business seems to come in waves. It'll be totally quite and uneventful for 2-3 hours and the suddenly three people will show up basically at the same time and once their gone it's quiet until the next group of people suddenly appear. I'm not sure but maybe there's data somewhere showing how accidents occurring between 2300 - 0700 happen in a cyclic fashion. Maybe I'll have to try and look that up later.
Anyway, here I am on a scooter:
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