Hello Trauma

The staff on Yebuah - maternity and labor and delivery.

A wonderful and fun bunch to work with.

The Sister of Yebuah ward - Leftenet Colonel Kanadu, working hard!

A few weeks ago I said goodbye to Yebuah ward and the pregnant women and babies and went to Trauma Emergency. This has been an interesting switch and I have definitely felt more at ease with my nursing skills in Emergency. As I mentioned in an earlier post, the single most common cause of trauma in Ghana is road traffic accidents (RTAs). I have seen this to be very true as a great majority of patients who come into Trauma Emerg are there because of an RTA.

After working a few shifts in Truama I suddenly became very aware of the risks associated with crossing the street. While normally I love an adrenaline rush…after seeing first-hand the injuries associated with an RTA, it’s not so enticing to run across three lanes of traffic. A lot of the accidents involve pedestrians, as it is a very dangerous business to be a pedestrian in Accra. While there are some cross-walks if you choose to use them you still take a big risk as the cars do not slow down, only honk their horn!

One case was particularly interesting, as a man and woman came in after an RTA. The man had been driving his motorbike and somehow hit the woman who was walking on the sidewalk (see even the sidewalks are not safe!). The man suffered minor injuries to his face and was quickly cleaned up and released. The woman had some abrasions and lacerations but nothing too serious. After the doctor had finishing suturing a deeper laceration, they were ready to discharge the woman, but as she got off the table, we noticed a fair amount of blood left on the table.

Lifting up her skirt to expose her thigh, we were horrified to see a massive hole in the woman’s thigh, with a severed tendon hanging out. I think a golf ball could have fit flush inside this hole. All over her thigh and skirt were little chunks of flesh and tissue. For those of you who are health care personnel and are wondering why this woman wasn’t “exposed” in the ABC’s of trauma…the woman absolutely had refused to have her clothing removed, and as there happened to be a shortage of sheets the nurse did not make her.

The craziest thing about the whole situation was that the woman gave no indication that she might have any such injury. She had moved herself from the wheelchair to the bed and back. She did not complain of any pain. This is probably due to shock, but may also have cultural implications. The doctor explained that this woman was from northern Ghana, where it is expected that an individual does not show response to pain. As we have been adjusting to working in the Ghanaian culture, I am constantly amazed at the differences.

Another observation we’ve made is that if a fracture is queried, you can count on there actually being a fracture, and a complex one at that. It seems in Canada, that we take a lot of x-rays to rule out fractures and generally find that there is no such injury. In Accra, it seems that due to the mechanism of injury, complex and ugly fractures are common. The cases involving children have been the hardest for me to work with, as it is terrible to see such trauma and injury to such young children.

Overall Trauma Emerg has been very interesting. I have two days left and next we move on to the Mamprobi Polyclinic (and I will share details on that when we find them out!). You can check out Erin’s blog for more Trauma Emergency stories.

I have had the opportunity to work with my friend Ginger on the ward, which has been such a blessing. It is so wonderful to have someone who can understand and relate to what I am going through.