I’m suctioning out his mouth as he vomits all over everything. He has it caught in his throat. His blood oxygen plummets. “Where is the oral airway, why isn’t it here!?” He starts breathing again. But his oxygen reads in the single digits. I suck out his mouth, then bag, bag and suck. His oxygen slowly starts to pick up. We have been in the OR 3 hours and have still not gotten his Achilles tendon repaired. He has been moving all over and I cannot get a good enough view of the back of his
leg to hit the moving target. The nurse giving anesthesia is giving repeated doses of Ketamine and some valium. That’s when he started vomiting. Meat and corn mush are coming up. I feel nauseated as he vomits on my arm and I feel some hit my face. The smell is impossible to avoid. I feel like joining him in the vomiting frenzy. He stops breathing and his saturation drops to single digits. Finally I’m able to clear his airway and it comes up to 88 (still below normal). He starts moving all
over again. Then vomits, drops to low digits… we repeat the cycle many times. He vomits probably 15 times. Nearly dies 3 times. At the end he is not fighting any longer. I hope he is not brain dead. He is stable enough that the nurse takes over bagging him. I decide I might as well repair his tendon while he is still and we have to keep bagging him. I repair his tendon and skin in about 10 minutes, now much easier with a still target. He starts breathing enough to keep up his own saturation
with a mask. We clean off a lot of vomit off of him and transfer him to his room with the oxygen concentrator. His family chose a private room so there is an electrical outlet in the room. I come back home at 3AM. Not at all tired. I shower off trying to rid myself of that odor. Finally with writing this I’m tired enough to go to bed, 4AM. Guess Ill get two hours tonight. Tomorrow I’ll wish I had a partner to take call.
This is a Koza business man and 8 armed thieves came into his house and beat up everyone, stole approximately $8000 and then before leaving cut his Achilles tendon. I guess so he couldn’t chase them. I don’t think I would chase 8 guys with guns anyway. I’m surprised that there is even that kind of money here in Koza. As everywhere there is the very rich and very poor.
Now two days later. He is doing well. He is not brain damaged. I put a splint on his arm where he has some ligamentus injuries. He removed this and the traditional bone setter put wood splints on it and wrapped it in a elastic bandage. More trust in them it seems, at least for bones anyway.
The population has apprehended 3 of the thieves and dealt with them in different ways. One was brought to the hospital for treatment and was released a few hours later. They were from a few hours away and had local accomplices. This is apparently the first large robbery in Koza. Before its been for cows, sheep and goats. Large city violence in a rural town. We thank God for His protection once again. Greg

Shanksteps #89

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