Save Lives with Emergency Care in Uganda

GEC emergency care practitioner with more than 10yrs of experience share her utrasound training skills while working at the Emergency Unit. Few weeks a go I was working at accident and emergency department at Masaka regional referral hospital Uganda, we received a middle aged man who was involved in road traffic accident

The man was restless and the blood pressure was going low yet there was no obvious bleeding. The pelvis was stable; we thought that maybe he was bleeding from chest, abdomen or long bones, on doing bedside ultrasound scan, there was no bleeding in the chest, abdomen and the long bones were stable, no signs of spinal injury. All doctors were puzzled on why the gentleman had unstable blood pressure and was deteriorating. We resuscitated the man, I repeated the FAST exam still was negative. As they were planning to take him outside the hospital for a CT scan. I told them to turn the patient because he had not been turned may be because he was big, on turning him, we found a very big hematoma at the back almost covering the whole back.

Meaning there was bleeding that could not be seen with ultrasound however much I repeated the scan.

It was since then that all Emergency staff learnt that in trauma if it is not the chest, abdomen, pelvis or long bones, there is re troperitoneal bleeding that will not be seen by ultrasound scan and can be life threatening.

Lesson was: Even if we use bedside scan to identify life threatening injuries, never forget ABCDE

Approach in emergency, in this case the patient was not turned due to the fact that he was a big patient. Whether the patient is small or big they have to be assessed systematically.

In the last three months, GEC emergency Care Practitioners treated 340 patients at the EmergencyDepartment with 172 admitted, 164 discharged, 2 were referred and 2 died on at the Emergency department.

Patient Demographic:

        I.          55.9% treated patients were Males.

      II.          44.1% treated patients were Females.

     III.          28.2% treated patients were children aging (0-15)

71% treated patients were adult