Freshly Made

There was an article in the paper this morning about the trip.

Medical Team Headed for Surgery Blitz in the Carribean

Medical Team Headed For Surgery Blitz In Caribbean
May 12, 2005
By GARRET CONDON, Courant Staff Writer Things routinely get busy for Dr. Ibrahim Daoud at St. Francis Hospital and Medical Center. But the general surgeon's workload will really go up beginning this weekend.

Daoud is leading a team of 33 doctors, nurses, technicians and interpreters in a one-week blitz of surgery on as many as 150 patients in San Jose de Las Matas, a remote community of 45,000 in the Dominican Republic. The team leaves St. Francis on Friday.

"I usually do about 20 operations a week," said Daoud, who will be making his fifth annual trip to the Dominican Republic. "We're going to be doing - as a team - about 20 a day."

The procedures range from gallbladder surgery to hysterectomies. Each of the participants carries two pieces of luggage, one with clothes and personal necessities, the other stuffed with medical supplies such as gloves and sutures, donated by St. Francis and various drug companies. Daoud's patients have donated $2,150 in cash.

Daoud's team, which is drawn mainly from the ranks of St. Francis employees, is sponsored by Medical Ministry International, a Texas-based evangelical Christian organization that deploys volunteer teams to needy locales throughout the developing world. Although the first priority is healing bodies, some MMI volunteers also tend to willing souls by praying and reading passages from the Bible. Neither prayer nor conversion is a condition for medical care, which is given freely to the poor, said Russell Browder, communications director for MMI.

The medical team will stay in a rustic dormitory during the trip - except on the last night, when it will stay in a hotel in Santo Domingo, the nation's capital. Daoud said he has a waiting list of clinicians and technicians eager to go .


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Started the day out with a code. Asystole. ALS resucitation for 20 minutes. Intubation. IV. 3 epis. 2 atropines. Still asystole. Called the time.

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Our state medical advisory committee is working on a state presumption/cessation of resuscitation policy that will require us to call medical control prior to termination. While I support statewide protocols, I am working (unsuccessfuly so far) in opposition to requiring doctor permission fto terminate asystole codes that have gottten their 20 minutes. These patients are dead and are not coming back. If you were guaranteed that the doctor would go along with termination that would be one thing, but when the odds are high that the doctor answering the phone is a moonlighter or someone unfamilar with prehospital protocols, you will inevitably have many of them telling us to continue working the code and bring it on in.

Here's an interesting discussion on the general issue.

Adios, Rampart

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Did a patient with chronic constipation, got called for a pulled chord at an elderly housing complex, (where the chord switches have a habit of falling down on their own -- and has always we were cancelled before arrival) and a stroke at a nursing home.

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Had lunch at a Chinesse Buffett. Got there at 11:00 which is the best time of day -- all the food comes out freshly made.

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Did a diabetic refusal -- a regular. Guy was vising someone's house and dropped his sugar down to 30. I thought I recognized him. It took me three shots to get the IV. I never had a problem with him before.

I think it happened because I semi-trashed another medic this afternoon. I saw a first responder who was on scene at a call I did not go to -- but I heard about both the call and the patient outcome later. I was curious whether it was a hospital screwup, a prehospital screwup, a dual screwup or no screwup at all.

So I asked the guy who was there what the deal with the call was and he told me what he saw.

I asked who the medic was and he told me, and that made some sense to me because the medic was not someone I considered a strong medic and then I told the guy who was there that.

As soon as I said it, I knew I would pay. Throughout my career, I have found that whenever I say anything bad about someone else in EMS, I end up doing something that makes me look bad.

So I go to this call, and with the same first responder I had semi-trashed the other medic too, I blow two not that difficult IVs before finally getting one in. All the time I am thinking, he is sitting there shaking his head at how can I miss these IVs.

A good rule is never to judge anyone unless you were there. There must be a passage in the Bible that would be appropriate. Maybe I will ask some of the more religious mission-goers that. I am always open to self-improvement.

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Sorry to be so vague in describing the above. As much as I want to record just what it is like to be a medic, there are many areas and things I just can't get into for judgement, fairplay, and liable reasons.

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One of the newer EMTs just came in for the evening shift. He is a good kid and he often brings pizza, so I just had a slice of pepperoni.

The night crew has been playing lots of good natured practical jokes on him. One night they showed him how the body bag works, rolled him up in it, then, as they had arranged, the horn goes off, and they are dispatched to a train wreck, and unable to disentangle him quickly, they leave for the big bad one.

Another night, after he has fallen alseep in a chair, they pull open the shades, open the windows, pull up two ambulances with their lights off, then all at once, hit all the lights and sirens on, while shining the higbeam spotlights in the kid's eyes. He woke up like Daffy Duck. Who? What? When? Where? Why?

Last week I guess they had him in the back, and pretended to stall on the railroad tracks with the train coming.

There's probably something in the Bible about that too.

But the kid seems very happy to be here. It's a beautiful evening.

I'm happy too. It's crew change. I won't be working again until May 24. I'm off on a grand adventure, and hopefully will have much to report on when I get back.