TB Tents

Monday Ellen, Jameson (our translator) and I worked in the tents for about 11 hours. It was a pretty usual day-wound dressing changes, cleaning people up, starting IVs, drawing labs, etc. Then a woman came in who had really bad respiratory distress and Megan wanted to get an IV started asap, then get her on oxygen, do some fluid resuscitation, and start on a thoracentesis (her right lung was filled with fluid up to around her heart...the procedure goes in through the space between your ribs and pull fluid out with a syringe). Megan wanted to get 500ml out and we ended up getting around 150ml in around 1 hour and a half. We tried to start multiple IVs but she was extremely dehydrated and so almost every IV we started infiltrated (her arm blew up bc the IV was not in her vein, it was in her tissue space). So as we are trying to get fluid in her, we are having two people hold the syringe...one steady the bottom and the other pulling the plunger (an hour and a half in the TB tents with no break you lose a ton of fluid and most of it seems to come out of your head and in your mask) We wear special masks when working with TB patients to decrease the transmission. Anyway, after the thoracentesis was finished we tried to put in a internal jugular line (on your neck, close to your carotid artery). Eventually we got one in and left the patient and her brother to watch the line. With that line in you have to stay extremely still or it will pull out easily. We had to use an ultrasound to find where it is and place the catheter.

So we were walking outside of the tents and someone came up to us and said "Dr. Coffee?" and pointed to their neck. Immediately I dropped my bags and sprinted to the tent where the woman had the line in her neck-I thought that it had come out and it was potentially squirting out. IT WASN'T but I figured it was a good first reaction, an amateur one, but still a good thought. The IV came out of her neck but she was not bleeding. Eventually they put a line in her femoral artery (leg). She passed away later that night and it was sad to hear. Her brother was an amazing man who helped out a lot in the tents with anything and everything. He should have been getting paid but of course was not. Generally in the tents if you have family you get taking care of, cleaned up, etc. If you do not then you hopefully get lucky and have ellen, megan, or I clean you up...BUT sometimes other families help take care of other patients without families. The nurses here do not clean patients, it is up to the family.

Tuesday we ran some errands, and today we worked in the tents again. Ellen and I are kicking but at putting in IVS and drawing labs. Pretty awesome considering it was our 4th day.

I love everyone and will hopefully update again soon.

PS went to an orphanage tuesday...that is my high for the week when we go and get to play with kids. I will post pictures on snapfish from the orphanage, http://www2.snapfish.com/snapfish/thumbnailshare/AlbumID=2372139021/a=1455062021_1455062021/otsc=SHR/otsi=SALBlink/COBRAND_NAME=snapfish/.

ENJOY!!