Partners Centers of Expertise (COEs) are innovative cross-specialty educational opportunities that allows trainees to explore areas of medicine and health care delivery relevant to all specialties such as medical education, quality & safety, global & community health, and health care policy & management. This blog is authored by trainees who have received a travel grant and their experiences.
Friday, June 7, 2019
Clinical Elective in Trauma Emergency Department at Groote Schuur Hospital, Cape Town, South Africa Part 2
Resident, Harvard Affiliated Emergency Medicine Residency
May 30, 2019
Bruising from a sjambok
busiest times at Groote Schuur Hospital are weekend nights. On one such
weekend night, we heard a bell go off, which would be a sign to everyone in the
trauma section that a patient was being brought to the resuscitation unit. When
we arrive, the EMS providers tell us this patient was involved in a community
assault. This is a form of vigilantism. Distrustful of the local police force,
a community mob will attack a person who was involved in a robbery or other
crime. Instead of calling the police, the mob (often 20 or more people,
including children) will take it upon themselves to punish the offender, often
beating him with bricks, sticks, and sjambok (whips) until his family members call
an ambulance or the police. Here you can see bruising marks from the sjambok.
patient had multiple lacerations around his scalp, multiple skull fractures
around his occiput, bilateral hemopneumothorax, right humerus and femur
fractures, but luckily no intra-abdominal injuries. He was placed on a
special stretcher that is used to take a full body x-ray with the special x-ray
machine that is located right in the resuscitation room, the Lodox.
receiving bilateral chest tubes, intubated, and given blood, he was stable
enough to rush to the CT scanner (3 hallways away). Rather than a mobile
ventilator, a doctor bags the patient the whole way, with
epinephrine/adrenaline and fentanyl in their pocket. Only after first
receiving a brain CT, showing a non-fatal head bleed, did the radiologist
consent to further scans of the c-spine, chest and abdomen. The patient
eventually went to the operating room with orthopedics. This was one of eight
resuscitation patients of the night.