Ambulance Roulette

"The ambulance here is used for everything", Fr. Geordani explained to me today. 

This morning I possibly would have gone in the ambulance to the Dominican Republic to fill small oxygen tanks, but was informed that today would not be a good day to go.  Presidential elections were yesterday and conditions might not be entirely predictable. In fact Fr. Geordani used the ambulance just last night to take two people who were shot in Cap to the Domincan Republic for safety and care. Thus, I went to the clinic and started triaging. 

TANKS SANS OXYGEN

One patient came in grasping her relative's waist as she walked in. She was clearly in respiratory distress, with trach tug, flaring, grunting and RR in the 40's. The nurses didn't seem fazed in the least.  Next door to the doc we went. He ordered an H&H, stool exam for parasites and a test for typhoid. Lungs seemed clear, that is in this loud clinic. I suggested an IV and a neb. He ordered Ibuprofen for her fever and IV fluids. IV started, 2 atrovent neb treatments and 4 puffs of albuterol later, she was still retracting but less severely and lungs were clear and open. St. Francois de Sales has no oxygen except for in the operating room. That tank is gargantuan, hooked up to the anesthesia machine and I could find no way to administer it to her. In my mind I thought, "She should be transferred to Justinian Hospital in Cap.", and so I tried to convince the doctors she could brochospasm more severely in the near future and that we should consider transferring.


A few minutes later, a woman who had drank battery acid was brought in with screams of pain. Soon thereafter, we were on our way to Justinian. A couple minutes into the ride, the patient ceased to breathe and was pulseless. I started CPR while thankfully the doctor drove on the pothole laden, bumpy road, swerving around motorbikes and trucks to Justinian. No oxygen to give her, I was it. I was unable to open her jaw, so I opened her airway the best I could and breathed into her nostrils, her eyes blank and body flaccid. I thought she was gone for good as we were jostled about. I have never given CPR in an ambulance before and it was a jerky transition between compressions to administering breaths.  At about 4-5 minutes into the ride she blinked, no respirations, but a sign of hope. I shouted to my valued translator, tell her to breathe! She barely nodded no. After the quick ride, about 10 minutes, she was blinking but not breathing. I gave two last rescue breaths then she was lugged from the ambulance, into the hospital. After that, I didn't lay eyes on her.  Later today, I thought to call the American nurses that I'll be working with tomorrow in Cap-Haitien. They happened to be @ Justinian hospital and will try to check on her. 

HOPITAL ST. FRANCOIS DE SALES, VAUDREUIL

I know God's love is with us. I couldn't have known that today, of all days, we REALLY needed the ambulance here! I could have been in the DR getting oxygen or could have chosen to bring the respiratory pt to Cap. and not returned in time for the patient who really needed it. There would have been no way we could have transported the poisoned woman to Justinian Hospital quickly without the ambulance! If you pray, please do so for her and her family!  Thanks for everyone's thoughts and prayers for the Haitian people and for me individually!