A day in the Emergency Department (aka "The ED Tent")

On average, we saw 80 patients a day from 8am till 11pm-ish...

The patients were suffering from a wide variety of complaints, however, most of the people we saw were in a very real need! I am totally amazed at the team members working in our Triage... they saw hundreds of people presenting for help/treatment each day, yet they only sent us 60 or 70 of the most sickest patients to see and treat per day. The other 10 or 20 patients we saw per day were coming in by military ambulances, UN, and transport vehicles from outlying clinics, villages, etc...

Dehydration, abdominal pain, the UTI's, malaria, fevers, Asthma attacks etc... The traumas started when it started to get dark... auto accidents, gunshots, stabbings, assaults... Kudos to Elena, Amy, Kristi and Laura! It took, on average 15 minutes from arrival, through stabilization and X-rays, to get to either the OR or admission! (Battlefield Medicine at it's finest!) I was very impressed with Elena... pushing Doctors out of the way, to get access to the patient to provide the most basic of interventions... I wish a few facilities and doctors could have experienced this! It would change their view of Trauma Care!

Had a few late nights too... just finally falling asleep around 1:00am, only to be awakened because a woman was in labor... I got to help deliver a baby, another patient came in, then 3 traumas... assault, gunshot, and auto accident... when it was all done and we were ready to go back to bed... yet another woman in labor! As I began to notice that it was getting light out, I looked at my watch and saw that it was 5:30am... only 3 1/2 hours of "sleepable" temperatures left! One of a few 20+ hour days...

The people I worked with were awesome! Although we had a lot of positive experiences and outcomes in the ED, we also had a few negative ones. As a team, we took interest in a few of the patients we treated. Following up on them, it was heartbreaking, and quite a few tears were shed, when we learned that some of our patients ended up dying a day or two later. We gave everything we had to help them, the word "frustrating" doesn't even begin to express our feelings!

I am also very proud of the rest of our team! The Nurses went way over "above and beyond!" From the OR, the ICU, the Med/Surg tent... They pushed well past what would be considered "normal nursing." 25+ patients per nurse in the Med/Surg tent... sometimes even more than that!

One of the most interesting things I experienced was what went "missing" overnight from the ED. We were in a tent, really an awning... all of our supplies, equipment, etc. was totally unsecured. All of the medications including narcotics were just sitting on a shelf. I would arrive in the morning and do an inventory of supplies we needed for the day. The two things that were always gone...

the bottle of Ibuprofen and baby diapers!

The narcotics (morphine, Versed, Valium, Fentanyl)... untouched! It was that big bottle of those little "orange pills" that was always gone! The baby wipes and diapers as well!

I witnessed some amazing things while in Haiti... Elizabeth Durham, getting some of the kids to just play...


Che' the respiratory therapist put together a "battle-field" CPAP that we used to help a Haitian man that was having a severe and prolonged asthma attack... This man took 3 days to get to us... we were able to break his asthma attack, admitted him, and he ended up having a repeat episode and died three days later...

Over all... I am thankful and grateful that I was able to go to Haiti. I am proud of my fellow team members that went! Although we had some varied experiences, I know that we helped and made a difference to at least one person... for me, that is enough!

Ray