Day 5 - Day 3 in Cruz Verde Norte Urgencias

First thing in the morning I was met by Luis, who introduced himself and gave me my ambulance shirts and GMP lanyard, shortly after he left Arielle showed up to give me a second Spanish lesson. We went out for a coffee and she showed me where the local laundrette which unfortunately turned out to be closed.

In the afternoon I was back at Cruz Verde Norte Urgencias and this time none of the staff spoke any English, using what little Spanglish I knew I was still able to get very involved and despite the language barrier the staff were very accommodating (often using google translate to communicate). 

During the first hour or so we received an open fracture to the ankle, myself and one of the doctors cleaned the bone and wound before I was tasked to pin the patient down whilst the bones were realigned without analgesia. Upon realignment (and a lot of swearing) I then dressed the subsequent wound whilst we waited for a transfer for surgery.

Shortly after, a small girl arrived with a deep laceration to the chin, she was very agitated and would not allow anyone to treat her, more so when she saw the needles for the analgesia. Again I had to hold her down and stop her thrashing about whilst one of the doctors cleaned and sutured the wound.

Several more patients presented requiring suturing, mostly hands and fingers and as such I was allowed to crack on and do it myself, the most notable of which was a fingertip that had been partially amputated, and I was tasked with re-attaching it. (shown below).

My final job of the day was a cardiac arrest that was brought in by one of the ambulances. The middle aged female was asystolic on arrival and therefore I immediately commenced with compressions. Much like in England, the rhythm and a carotid pulse is checked every two minutes during resuscitation. The woman was intubated and after approximately six minutes of CPR we achieved ventricular tachycardia and subsequently a shock was delivered. We continued CPR for another three cycles when upon the rhythm check we found the patient to be in normal sinus rhythm. She was then attached to a ventilator where over the next fifteen minutes her observations seemed stable with a heart rate of around 80 and sats of 94% also with a radial pulse. Shortly after this she then deteriorated and re-arrested. After discussion with the family it was decided to stop all resuscitation attempts.

Tomorrow I start my first shift on the ambulance, so until then buenas noches.

(my fingertip reattachment)