Anaesthesia

It has been very busy-- Lots of interesting cases. I cannot believe the things that I’m doing such as reducing fractures, putting cast on, doing xrays including developing the xray films in the darkroom and ultrasounds (there is a portable ultrasound in the size of a large laptop). I’m even giving anaesthetic to reduce fractures or to do incision and drainage or debridement. A month ago I would have said you’re mad. The anaesthetic I use here is IV Ketamine. It’s one of those anaesthetic drugs that I only read and heard of during medical school. That is no longer used in western world. It’s quite an effective anaesthetic. The only nasty thing is they don’t close their eyes, and they have this glassy eye look and sometimes they get bad reaction when they get up from the anaesthetic--they can get hallucinations. So far everything has been good. No one has reacted badly. One 8 year old girl got up making jokes and was quite funny really. She had a difficult rare fracture and I tried as much as I could to try to reduce it. There’s a couple of difficult fractures. Another one is a 15 year old girl with a femoral (thigh bone) fracture. We really need a Steinman pin to give her traction but we have no Steinman pin here and so we are using skin traction. All my non medical friends, sorry for this sort of boring information but my medical friends would appreciate it.

The above is the skin traction of the femoral (thigh bone) fracture. As you can see the weight for the traction is a tin bucket with sand and water in it. In the end I had to re-do this skin traction as the previous tape was too elastic and came off her skin, so we got a better tape to stick to the skin, and we had to add more weights so two iv fluid bottles were added to the tin bucket on the side.


This is another attempt to reduce a fracture. Her fracture was caused by a big branch falling on her arm. As you can see this girl is still in the xray room. It's not a bad xray room and even has air condition when the power is on. When the xray work, it has a battery so you could still do xrays even the power is out. The only problem is developing the film because then the dark room is literally dark. One has to be careful as I've got the chemicals onto my hands in the dark before. I've used IV fluids for weight for this girl. Her poor mother cried when she saw her child under anaesthetic as I've said their eyes are open with a glassy look (not very settling)--I always see their chest to see if they are breathing and they always are. She's the one that got up from the ketamine anaesthetic making jokes of all sorts.