Tuesday, March 18, 2008
Cleaning up messes
One thing this hospital almost specializes in is cleaning up messes by other hospitals. When a patient visits a government hospital here, to get any kind of care, the patient must pay up front. That is not possible for many patients. They end up staying at the hospital, not getting treated, usually allowing the condition to get worse.
Today, I performed an incision and debridement with Dr. Hewitt on such a patient. She had fallen in a gutter, causing an infection in her leg. She spent the last 5 days at another hospital, receiving no treatment because she could not pay. People have to pay up front here for elective surgery and many procedures, but all emergencies we treat first. And if a patient absolutely could not pay, they do have "special needs" which helps find money for the patient. We were forced to cut open a huge chunk of her leg, basically from mid-thigh down to her ankle. There was necrotic, pussy tissue everywhere. It was nasty!
What you can't see in that picture is that when we opened her up, the pus pockets went all the way up her thigh. The only way to get the infection out here is to open them up, then continue to debride them every few days. You also can't see in the picture how smelly of a process this is.
Then there are cases where we have to clean up accidental messes of another facility. A 3 yo male had a tourniquet placed on his right arm for some procedure, the staff never remembered to take it off. Dr. Faile was forced to amputate the hand. It's a big deal here to not have a right hand, because they eat with their right hands here.
Posted by ESK123 at 12:24 PM