It was very, very good

By Volunteer, Dr. Carolyn Apple

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The phone rings in the volunteer house.  I glance at the clock – almost 10pm.  This is not good.  The voice states a patient has been brought by family to FAME after having a motor bike accident and appears to have a head injury.  Can I come?  This is not good.  A few minutes later, I am standing by Dr. Gabriel and Dr. Kiduge looking down at a young man with abrasions to his face, scalp and shoulders.  The patient occasionally calls out nonsense and only arouses to pain. This is not good. The FAME team has already placed a cervical collar and started the initial assessment and stabilization of the patient and Dr. Gabriel performs a focused abdominal ultrasound for trauma exam – no evidence of blood in the abdomen/pelvis. This is good.  We proceed through the remaining primary and secondary assessments taught in trauma care. The patient becomes agitated, requiring cautiously administered sedation.This is not good. Within minutes, a FAME nurse anesthetist is at our side, helping with sedation and airway management.  This is good.  Laboratory study results return and blood typing has taken place.  This is good.  We are notified the radiology technician has arrived and X-rays and CTs are performed quickly.  This is good.  The CT reveals a subdural hematoma.  This is not good.  CT of the cervical spine and x-rays of the chest and pelvis are negative.  This is good.  Dr. Loie Sauer, a volunteer surgeon, joins the team.  This is good.  The team confers and quickly agrees the patient needs a referral for neurosurgical care.  The family agrees to a transfer.  This is good.  The local ambulance is called as the patient receives continued monitoring, medical and nursing care from the team.  This is good.  The ambulance arrives and the FAME nurses equip the vehicle with the necessary equipment and supplies for transport. This is good. The patient is loaded up, along with the FAME nurse anesthetist who will monitor the patient’s vital signs, airway, need for additional sedation and general condition enroute.  This is good.  I return to the volunteer house three and a half hours after having left my bed.  What the FAME Medical team was able to do tonight was very, very good.