Monday evening Miami in Haiti...

I was just checking email Monday evening when our EMT here (who is in charge of the post-op ward) came in saying she needed a doctor. One of the caretakers on the ward was having chestpain. It ends up that she had a blood pressure of 240/130 and chest pain. Prior to the earth quake she was on anti-hypertensives, but because her house collapsed, she lost her medication and has not been taking any since. She has now had a headache for a few days and started having chest pain a few hours before I saw her. After assessing her, giving aspirin and sublingual nitro, I decided it would not be good to keep her here, and so we took her in to the Port-au-Prince Miami hospital. The same place I had been working at the previous few days. As we drove up I saw the ER doctor walking off so called after him. He was just on his way out, and the E.R. was closing for the night. Fortunately he was very kind to come back in to get my patient sorted and get another doctor to take over. She was stabilized further, given iv medication for her high blood pressure. And finally it started to come down. She started feeling a better but needed to stay overnight. So we left her there - on a ward with about 150 adults- with I think 3 or 4 nurses for all of those patients! Crazy. She stayed for 2 nights and they put her on oral medication. I just heard that she returned this afternoon so I will head over to post-op to see her there. It was an interesting but long night. I was glad to have been able to help. And glad it was an adult medicine situation that I could recognize and deal with...