Friday, June 7, 2019

Clinical Elective in Trauma Emergency Department at Groote Schuur Hospital, Cape Town, South Africa.


Kelsy Greenwald, MD
Resident, Harvard Affiliated Emergency Medicine Residency
PGY 2 

Groote Schuur Hospital - a hospital situated in gorgeous Cape Town, overlooking one of the modern seven wonders of the nature. And yet, a violent area, with a homicide rate of 62 per 100,000, and in the poorest sub-district of Khayelitsha the rate is 120 per 100,000 people. For comparison, Detroit’s homicide rate is 40 per 100,000.

Groote Schuur Hospital is a government funded public hospital, where most patients pay little to nothing for their care. It is a tertiary hospital and is well respected for its trauma care.  Many visiting physicians come from around the world to train at GSH. The trauma center alone sees 1300 patients each month, with 50 beds in total and 10 high care beds. The trauma center sees both blunt and penetrating trauma, intentional gunshot and stab wounds and unintentional motor vehicle accidents. The number of gunshot wounds is high, averaging 70-80 per month.  Groote Schuur Hospital is the referral site for many of the surrounding hospitals as it is one of two hospitals in all of Cape Town with 24 hour access to CT scanner (though it is still at least a 5 min walk/run from the resuscitation area). 

Shifts in its trauma unit are run from 8am-6pm, and a night shift from 6pm-8am. Each shift usually has 2-3 registrars, or residents, and 2 interns. Attendings round with the residents at each shift change, but otherwise the registrars run the trauma center. Most registrars work roughly 50-60 hours per week. The trauma center is split into three sections: green (the most stable patients, left in chairs), yellow (those that require a stretcher), and resuscitation (those that require monitoring – codes, unstable vitals, penetrating trauma to the chest or abdomen, or those with Glasgow Coma Scales less than 14).

I spent my time doing 4 15-hour overnight shifts each week, from Thursday to Sunday, the times the most trauma occurred. I was able to learn from these incredible registrars who would see more trauma in one month than the residents in my home hospital would see all year. From crash chest tubes, to open skull fractures, hemorrhaging bleeds from stab wounds to the neck, and multiple chest and abdomen gunshot wounds, the registrars calmly and efficiently manage it all. I was incredibly impressed with the capabilities, knowledge, and courage of the South African residents.

28 comments:

  1. Replies
    1. I WILL CONTINUE TO POST THIS, I'm so happy to share this testimony thank you Dr.idowu  am so happy i never believed i will be herpes negative again despite all i passed through Dr.idowu you are truly God sent, am so happy that am negative again thank you Dr idowu.email him
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    2. Good day to all viewer online am so happy sharing this great testimony on how i was checking for solution in the internet then miraculously i came Across Dr.idowu the powerful herbalist that Cure Numerous individuals Herpes simplex Virus,so I contacted him base on the testimonies I?m seeing about him on the internet, I was cured too by him, kindly contact him actoday through his email he can help you email ; {dr.idowuherbalhome@gmail.com} and so he can cure types of diseases like,HEPATITIS B,DIABETICS,CANCER,HPV,LOW SPERM CAM HIV/STDS FIBROSIS LOST OF WEIGHT .. all thank to you Dr idowu for your kindly help in my life his whatsapp  number +2348052789941.{+2348052789941} if you have any problem you can contract him immediately save life pls ,yours health is urs  wealth ,is not  fake pls ,give him a trial ..thanks  you dr,idowu onces again,thanks you .

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  2. God bless Dr. USELU for his marvelous work in my life, I was diagnosed of HERPES SIMPLEX VIRUS since 2018 and I was taking my medications, I wasn't satisfied i needed to get the HERPES out of my system, I searched about some possible cure for HERPES i saw a comment about Dr. USELU , how he cured HERPES with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine within 3 days. I took the medicine as prescribed by him and 2weeks later  i was cured from HERPES contact him via email (dr.uselucaregiver@gmail.com) once again thanks to you Dr. USELU cure the flowing virus, contact his email or add him on whatsapp (+2349019328641) cancer cure
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    Replies
    1. Good day to all viewer online am so happy sharing this great testimony on how i was checking for solution in the internet then miraculously i came Across Dr.idowu the powerful herbalist that Cure Numerous individuals Herpes simplex Virus,so I contacted him base on the testimonies I?m seeing about him on the internet, I was cured too by him, kindly contact him actoday through his email he can help you email ; {dr.idowuherbalhome@gmail.com} and so he can cure types of diseases like,HEPATITIS B,DIABETICS,CANCER,HPV,LOW SPERM CAM HIV/STDS FIBROSIS LOST OF WEIGHT .. all thank to you Dr idowu for your kindly help in my life his whatsapp  number +2348052789941.{+2348052789941} if you have any problem you can contract him immediately save life pls ,yours health is urs  wealth ,is not  fake pls ,give him a trial ..thanks  you dr,idowu onces again,thanks you .

      Delete
  3. I WILL CONTINUE TO POST THIS, I'm so happy to share this testimony thank you Dr.idowu  am so happy i never believed i will be herpes negative again despite all i passed through Dr.idowu you are truly God sent, am so happy that am negative again thank you Dr idowu.email him
    (Dr.idowuherbalhome@gmail.com)
    If you have any problem like
    *Herpes 1/2,
    *HIV/Aids,
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    *Breast cancer/cancer,
    *Marriage,
    *Pregnancy problem,
    *Ex back, 
    *Penis enlargament/ass,
    WhatsApp him via (+2348052789941)
    Please give him a try ,no harm in trying ok....

    ReplyDelete
  4. I WILL CONTINUE TO POST THIS, I'm so happy to share this testimony thank you Dr.idowu  am so happy i never believed i will be herpes negative again despite all i passed through Dr.idowu you are truly God sent, am so happy that am negative again thank you Dr idowu.email him
    (Dr.idowuherbalhome@gmail.com)
    If you have any problem like
    *Herpes 1/2,
    *HIV/Aids,
    *Hepatitis a,b,c,
    *Breast cancer/cancer,
    *Marriage,
    *Pregnancy problem,
    *Ex back, 
    *Penis enlargament/ass,
    WhatsApp him via (+2348052789941)
    Please give him a try ,no harm in trying ok....

    ReplyDelete
  5. Good day to all viewer online am so happy sharing this great testimony on how i was checking for solution in the internet then miraculously i came Across Dr.idowu the powerful herbalist that Cure Numerous individuals Herpes simplex Virus,so I contacted him base on the testimonies I?m seeing about him on the internet, I was cured too by him, kindly contact him actoday through his email he can help you email ; {dr.idowuherbalhome@gmail.com} and so he can cure types of diseases like,HEPATITIS B,DIABETICS,CANCER,HPV,LOW SPERM CAM HIV/STDS FIBROSIS LOST OF WEIGHT .. all thank to you Dr idowu for your kindly help in my life his whatsapp  number +2348052789941.{+2348052789941} if you have any problem you can contract him immediately save life pls ,yours health is urs  wealth ,is not  fake pls ,give him a trial ..thanks  you dr,idowu onces again,thanks you .

    ReplyDelete
  6. Good day to all viewer online am so happy sharing this great testimony on how i was checking for solution in the internet then miraculously i came Across Dr.idowu the powerful herbalist that Cure Numerous individuals Herpes simplex Virus,so I contacted him base on the testimonies I?m seeing about him on the internet, I was cured too by him, kindly contact him actoday through his email he can help you email ; {dr.idowuherbalhome@gmail.com} and so he can cure types of diseases like,HEPATITIS B,DIABETICS,CANCER,HPV,LOW SPERM CAM HIV/STDS FIBROSIS LOST OF WEIGHT .. all thank to you Dr idowu for your kindly help in my life his whatsapp  number +2348052789941.{+2348052789941} if you have any problem you can contract him immediately save life pls ,yours health is urs  wealth ,is not  fake pls ,give him a trial ..thanks  you dr,idowu onces again,thanks you .

    ReplyDelete
  7. Good day to all viewer online am so happy sharing this great testimony on how i was checking for solution in the internet then miraculously i came Across Dr.idowu the powerful herbalist that Cure Numerous individuals Herpes simplex Virus,so I contacted him base on the testimonies I?m seeing about him on the internet, I was cured too by him, kindly contact him actoday through his email he can help you email ; {dr.idowuherbalhome@gmail.com} and so he can cure types of diseases like,HEPATITIS B,DIABETICS,CANCER,HPV,LOW SPERM CAM HIV/STDS FIBROSIS LOST OF WEIGHT .. all thank to you Dr idowu for your kindly help in my life his whatsapp  number +2348052789941.{+2348052789941} if you have any problem you can contract him immediately save life pls ,yours health is urs  wealth ,is not  fake pls ,give him a trial ..thanks  you dr,idowu onces again,thanks you .

    ReplyDelete
  8. Good day to all viewer online am so happy sharing this great testimony on how i was checking for solution in the internet then miraculously i came Across Dr.idowu the powerful herbalist that Cure Numerous individuals Herpes simplex Virus,so I contacted him base on the testimonies I?m seeing about him on the internet, I was cured too by him, kindly contact him actoday through his email he can help you email ; {dr.idowuherbalhome@gmail.com} and so he can cure types of diseases like,HEPATITIS B,DIABETICS,CANCER,HPV,LOW SPERM CAM HIV/STDS FIBROSIS LOST OF WEIGHT .. all thank to you Dr idowu for your kindly help in my life his whatsapp  number +2348052789941.{+2348052789941} if you have any problem you can contract him immediately save life pls ,yours health is urs  wealth ,is not  fake pls ,give him a trial ..thanks  you dr,idowu onces again,thanks you .

    ReplyDelete
  9. I already gave up on ever getting cured of HSV2 because i have tried many treatment none of them worked out for me i have gone to different hospital they always tell me same thing there is no cure for herpes when i came across a post about Dr RAZOR on the internet from a lady called Angela[USA] i contacted him and he reassured me of the effectiveness of his herbal medicine and he sent me thy medication after he promised to guide me, i took the medication according to the way he instructed, within 18 days i started having some changes in me and i went to the medical hospital for check up and i was confirmed herpes negative. I doubted at first because i have been to a whole lot of reputable doctors, tried a lot of medicines but none was able to cure me. so i decided to listen to him and he commenced treatment, and under 18 days i was totally freed from #Herpes. i want to say a very big thank you to DR RAZOR for what he has done in my life. You can leave him a message on email drrazorherbalhome@gmail.com and also WhatsApp him +2349065420442..
    He might as well be able to get rid of
    1...ALS CURE/DIABETES CURE/EPILESY/HPV CURE/LUPUS/HEPATITIS/CANCER/GOUT

    ReplyDelete
  10. I already gave up on ever getting cured of HSV2 because i have tried many treatment none of them worked out for me i have gone to different hospital they always tell me same thing there is no cure for herpes when i came across a post about Dr RAZOR on the internet from a lady called Angela[USA] i contacted him and he reassured me of the effectiveness of his herbal medicine and he sent me thy medication after he promised to guide me, i took the medication according to the way he instructed, within 18 days i started having some changes in me and i went to the medical hospital for check up and i was confirmed herpes negative. I doubted at first because i have been to a whole lot of reputable doctors, tried a lot of medicines but none was able to cure me. so i decided to listen to him and he commenced treatment, and under 18 days i was totally freed from #Herpes. i want to say a very big thank you to DR RAZOR for what he has done in my life. You can leave him a message on email drrazorherbalhome@gmail.com and also WhatsApp him +2349065420442..
    He might as well be able to get rid of
    1...ALS CURE/DIABETES CURE/EPILESY/HPV CURE/LUPUS/HEPATITIS/CANCER/GOUT

    ReplyDelete
  11. Hello everyone i am very delighted that i recently got cured of herpes virus. I have been battling with this disease for over 4 years now, ever since i got diagnosed of the virus i have been using medical pills and therapies to suppress the virus. But inside of me i needed the Virus gone cause my health was deteriorating, So  i went on to the internet to search on how one could get cured from this virus, when i came across some testimonies on how herbalist razor has helped them get rid of Herpes virus, Hiv/aids, Cancer. I copied out his details (email ; drrazorherbalhome@gmail.com) and Whatsapp number +2349065420442) as provided by the testifiers on a blog site. But before that i was so skeptical, i knew there are so many herbal doctors on the internet,i needed the one who can help me get through this Herpes Virus completely with his herbal Remedy. I got in contact with doctor Razor,and i explained my problem to him and he promised to help me, which he actually did. I got my medication in the US sent by doctor razor and he instructed me on how i was to take it for 18 days. After the said 18 days i went for medical check up and the doctors ran some test on me and told me i was Herpes Negative, i was amazed and dumb-folded, so i had to go back home, i noticed my health for some months, i didn't have any outbreaks nor symptoms of the virus, but i went to another hospital after 2 months to conduct another test and the same result. I will be forever grateful to you doctor Razor and I will make sure the world gets to know about your herbal exploits sir. Reach doctor razor on his email : drrazorherbalhome@gmail.com or whatsapp/call his cell on +2349065420442

    ReplyDelete
  12. Good day viewer, I am Nurse Sonia kuffin from Austria . It has happened the way you said it will sir. Daddy am very happy today for your help in my life, doctor Chukwu Madu herbal home you cured me finally from Herpes virus, I was infected with this deadly virus in the year 2012 and i was
    taking my medications, I wasn't satisfied i needed to get the HERPES out of my system, I searched about some possible cure for HERPES i saw a comment about Dr CHUKWU MADU HERBALHOME how he cured HERPES with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine through UPS delivery company. I took the medicine as prescribed by him and 11 days later i tested negative for HERPES, Dr.CHUKWU MADU truly you are great,It's Good for herpes patient to please read my testimony becuase People think herpes is really a minor skin irritation,herpes has a long term effects on health and The stigma attached to this virus by ignorant people is ridiculous. do you need his help also? Why don't you contact him through his email (dr.chukwumaduherbalhome@gmail.com) .
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    9 pregnancy spell and bring back your ex back .
    10 scabies .
    He cures any kind if viruses and diseases.

    ReplyDelete
  13. Six weeks previously, I had attended my primary care doctor (PCD) with dysuria and was treated for a urinary tract infection, however, symptoms persisted. Several days later I noticed an acute onset of bilateral vulvar blisters. I was clinically diagnosed with genital herpes and commenced taking valacyclovir 500 mg bd for one week as instructed by my  PCD. The blisters resolved within five days, however, I developed burning and exquisite sensitivity to touch in both inner thighs and in my left buttock extending down my left leg and including the sole of my left foot and toes. I found that at times, I was unable to walk and sit. So returned to her PCD who told me to continue taking valacyclovir for another week, however, the burning persisted. And I knew this was never going to cure me. I sorted for Natural Herbs And Gos so good i came across doctor razor's Details,I contacted him and we spoke and he assured me everything is going to be permanently fine. Few days after I reached out to him he sent me herbal medicine to take for 18 days. after completing the dosage for 18 days. I started noticing some changes in my Genital Area. so i told the herbalist about it, he asked me to go for a medical test, which i did. Lo and behold, My PCD was surprised to see my result out Negative,. I was overwhelmed with joy, I waited for 2 weeks to make sure the Virus was not laying dormant in my Nerve Cells, So i went for another test After the two months, And it had the same Negative result. I am forever indebted to you Doctor Razor. If you are having hard times with this same virus or you do know of anyone with herpes virus, i kindly recommend you to him. Email drrazorherbalhome@gmail.com
    WhatsApp or Call his cell phone +2349065420442..,.

    ReplyDelete
  14. TO EVERYONE BATTLING WITH HERPES INFECTION ,I want to quickly drop my life story on how a specialized healer called DR RAZOR cured me from HERPES virus, A good man who have used his herbal roots and herbs to cure all kind of deadly disease. I was infected with HERPES virus and I never thought HERPES virus could be cured,but with the medication DR RAZOR sent to me i was cured,I saw his email on web page by a patient he has cured from HERPES,who dropped the email and phone contact of the doctor.I really thank FLORENCE for sharing her testimony on how she was cured When I contacted him he prepared the herbal medication for my HERPES cure and send it to me via DHL And i got cured within 18 days of using the herbal medicine,Contact him through E-MAIL drrazorherbalhome@gmail.com or for easy communication you can WHATSAPP/CALL him via his mobile number +2349065420442. He can Also cure Infections like :HSV 1 & HSV 2ASTHMADIABETESEPILEPSYCANCERINFERTILITYSTAPHYLOCOCCUS.BARRENNESSHIV /AIDSHEPATITIS B Kidney?

    ReplyDelete
  15. My Sincere Gratitude to Dr Razor, I was infected with HERPES SIMPLEX VIRUS 2 November 13 2018, I went to many hospitals for cure but there was no solution, I was confused because the medical drugs has become my daily food, but i decided to sort after Natural Herbs. One day I sat beside the pool, Browsing and thinking where I could get a solution to end this my predicament. I saw a blog on how Dr Razor cured people with his herbal medicine, i did not believe but i just decided to give him a try, Visit Doctor's Razor's Website : https://drrazorherbalhome.wixsite.com/drrazorherbalhome .I contacted him and he prepare the herbs for me which i took, and he instructed me to go for check up, after the test i was confirmed herpes negative, i am so happy. If you have any problem or you are also infected with any disease, kindly contact him now with his Email: drrazorherbalhome@gmail.com or call +2349065420442This testimonial serves as an expression of my gratitude.
    He also have a herbal cure for COLD SORE,
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    Contact him on this email: drrazorherbalhome@gmail.com , or call his cell phone number on +2349065420442

    ReplyDelete
  16. I never believed in Love Spells or Magics until I met this special spell caster once when i went to Africa to Execute some business. He is really powerful. The man i wanted to live the rest of my life with left me 3 weeks in our wedding ceremony and my life was upside down. he was with me for 6years and i really love him so much. he left me for another woman with no reason. When i called him he never picked up my calls and he don’t want to see me around him and he also deleted me from his facebook account. so, when i told the spell caster what happened. He helped me to do some readings,and after the readings he made me to realize that the other woman has done some spells over my husband and that is the reason why he left me. He told me he will help me to cast a spell that will bring him back. At first i was skeptical but i just gave it a try. In 4 days, he called me himself and came to me apologizing for all that happened. I never believed that he was going to come back but today i have him by my side with the love and care i was wanted from him. This man is good and he is the author of my happiness. His email is drkutaherbalcenter@gmail.com or his whatsapp+2347054547814

    ReplyDelete
  17. I appreciate all you have done for myself and my family. My name is Claire Smith i am from U.S.A,and after contacting so many fake spell casters that only played with my heart you´d got what I wanted: my family back. Your sincere kindness and thoughtfulness inspires me. You have touched my heart deeply and I will forever be grateful that you got rid of all the negative influences that surrounded my wife and I. Now we are back and my son i s very happy again, with his parents together… Thanks drkutaherbalcenter@gmail.com..or his whatsapp+2347054547814 .all my gratefulness

    ReplyDelete
  18. Thank God for using Dr. Patrick to get me cured from Herpes virus The disease appeared at the age of 38, with no hope of a cure from the hospitals i have went to, I thought my life have come to an end, until a friend of mine told me about Dr. Patrick who treats all Kinds of diseases including Herpes, I contacted him via his email: patrickherbalcenter1@gmail.com and purchased the Herpes drug which is in a form of liquid after preparation, I received the medicine through airwingexpressdelivery and i immediately commenced usage as prescribed, i used the medicine within 3 weeks that i was instructed and to my greatest surprise my result became negative I am Herpes free, and I won't stop rejoicing and giving thanks to God for using Dr Patrick to cure me, you can contact him for your cure or any kinds of drugs, contact his Whatsapp number +2348118116254 or email patrickherbalcenter1@gmail.com

    ReplyDelete
  19. All thanks to the great Priest Dr bow for helping me restore back my marriage when i taught all hope was lost.,this Priest helped me, and my relationship is now perfect. Contact for any spiritual work  (@Drbowsolutionhome1) Your partner will definitely love you email him Drbowsolutionhome@gmail.com or whatapp him +2348121786772

    ReplyDelete
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    Gastroenterolog

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  23. My ex-husband and I had always managed to stay friendly after our divorce in February 2017. But I always wanted to get back together with him, All it took was a visit to this spell casters website last December, because my dream was to start a new year with my husband, and live happily with him.. This spell caster requested a specific love spell for me and my husband, and I accepted it. And this powerful spell caster began to work his magic. And 48 hours after this spell caster worked for me, my husband called me back for us to be together again, and he was remorseful for all his wrong deeds. My spell is working because guess what: My “husband” is back and we are making preparations on how to go to court and withdraw our divorce papers ASAP. This is nothing short of a miracle. Thank you Dr Emu for your powerful spells. Words are not enough. here is his Email: emutemple@gmail.com or call/text him on his WhatsApp +2347012841542

    He is also able to cast spell like 1: Lottery 2: Conceive 3: Breakup 4: Divorce 5: Cure for all kinds of diseases and viruses.

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  24. I really appreciate the Great Prophet for returning my lover after 8 years of been together, i taught all hope was lost. Thanks to the Great Prophet for making me happy again. You can contact him and he will be of great help because he is a wonderful man? Mail him @ ( Drdodotemple@gmail.com). or whatsapp @ +1 (706) 871-4571

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  25. MY REVIEW ABOUT HERBAL DOCTOR KHAM PRODUCT THAT CURED ME FROM HERPES VIRUS IN TWO WEEKS OF TAKING THE DOSAGE.   Thank God I gave him a chance to cure me, I saw so many comments about him on how his product can get rid of herpes virus and other diseases and infection, this man is 100% real. Well, I notice there are still other fake herbal doctors online who have scammed me before, thank God for coming across Herbal doctor Kham, You can Also Visit his website to know more about him at http://herbalistdockham.website2.me/ or https://herbalistdrkhamcaregiver.simdif.com/ I am perfectly cured from the virus and my result came out negative after taking herbal doctor Kham herbal medicine for two weeks. you can also contact him on WHATSAPP +2348159922297 or via EMAIL: dr.khamcaregiver@gmail.com this cure is real, i can not keep this healing to myself because i know a lot of people are dying silently of this virus thinking there is no cure. I have been scammed several times so I do not want you to fall victim to those fake herbal doctors outside. That is why I refer you to the right herbal doctor which is Doctor Kham, Thank you so much Doctor. I will forever publish your Good work in my life. 

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