Sunday, January 31, 2010
A note from Dr. John Donovan, anesthesiologist (Alta Bates Summit Medical Center):
"It's only been a week since we spent our first night in Haiti at this facility, yet it seems much longer...in a good way."
Saturday, January 30, 2010
Canadian plastic surgeon, Dan Durand M.D. closes a large wound with Taylor Smith M.D. (orthopedic surgeon, California Pacific Medical Center), This is one of several reconstructive procedures performed recently as the focus of surgery shifts into a new phase.
Friday, January 29, 2010
“We continue to evacuate critically ill orthopedic patients. If we are unable to secure a helicopter transport, our next option is to take the patient via ambulance. It’s a long ride to Port au Prince and patients with painful fractures may not be able to tolerate the bumpy ride.
For several days we have been attempting to evacuate a woman with a severe femur fracture, which had become infected. We were determined to evacuate her, so we prepared to drive the patient to Port au Prince accompanied by an anesthesiologist.
Above Liz Petruzzella R.N. (California Pacific Medical Center) helps John Donovan M.D. (anesthesiologist, Alta Bates Summit Medical Center) perform a peripheral nerve block. The nerve block is used for hip surgery and helps manage the pain associated with transport.
While waiting for the ambulance, we suddenly learned that a helicopter was arriving to take her by air. We improvised, quickly folding down the seats of an SUV and driving to the landing zone with her legs sticking out the back (see photo below).”
Helicopter transports are usually done by the U.S. Navy. Here a corpsman accepts our critically ill patient.
Thursday, January 28, 2010
We were able to give her a blood transfusion her and her condition has much improved.
We’ve noticed a chance here in Haiti. "The acute phase of the crisis has passed but we are now entering a phase where patients are at significant risk of serious tissue infections. We had hoped to evacuate a critically ill adult patient in this condition – but were unable. There are countless cases such as this overwhelming the system.
To continue to help our patients here in Haiti, two Sutter Health-affiliated nurses are staying overnight at the hospital with patients that have major infections.
In the morning [January 28, 2010] I will be riding in an ambulance to Port au Prince with two patients. The roads are so rough and their wounds so painful that they need an anesthesiologist to go with them."
Our team’s time here is short but the people of Haiti will continue to need medical care for months to come.
Below, "while Taylor Smith M.D. (orthopedic surgeon, California Pacific Medical Center) operates, Isais Comacho R.N. (surgical technician CPMC) teaches a Haitian technician how to assist in orthopedic cases. St. Marc's techs have significant experience assisting on cesarean sections but have very little exposure to other cases.
Given the long road ahead for our patients, it is critical to bring local providers into the process."
"We started the day off with a relatively light day on the schedule. The thought crossed our mind that we might actually leave the hospital with daylight.
This changed quickly when we started to see pediatric patients with medical and surgical problems. We operated on a child with a ruptured appendix.
While we were rounding on patients doing wound care, we were frantically called to the ER to evaluate a critically ill 2-week-old child. Sutter physicians worked with Canadian colleagues to resuscitate the child who suffering from dehydration, sepsis and pneumonia.
Finally, we were able to set up a transfer to a larger Haitian hospital via a UN ambulance for our young patient. The vehicle was brand new and nicely armored but did not have medical staff.
Wednesday, January 27, 2010
Since transporting patients by ambulance to Port au Prince is extremely difficult, the Navy's USS Nassau sent a helicopter to pick up the patients. The Navy gave us a 10 minute lead time to get our patients to the 'LZ' or landing zone – a nearby soccer field.
Typically getting around town is relatively low key...but this changes when a helicopter lands in town.
The US Military has really stepped up to help with the medical situation. We hope to MEDEVAC several more patients in the coming days."
Tuesday, January 26, 2010
“Everybody helps to transport patients. Above Scott Taylor M.D. (orthopedic surgeon Alta Bates Summit Medical Center) goes to pick up an evening patient.”
“We have electricity most of the time [but still experience] period power outages. Below Susan Bailey M.D. (ABSMC) tends to a wound with a camping headlamp during one of the outages. The room was otherwise pitch black.”
“While days can go well into the evening, the hospital is not structured to enable us to operate day and night. We have to be sensitive to the volume of cases that the hospital can handle, particularly given that, despite our best efforts, we still must perform amputations.”
Above is “one of seven surgical wards.”
Monday, January 25, 2010
Above James Tussaint M.D. (Massachusetts General orthopedic resident,), operates with Susan Bailey M.D., chief of surgery at Sutter-affiliated California Pacific Medical Center (St. Luke’s campus), Cassie Kinser, R.N. also from CPMC.
Stay tuned as our busy team gives us more details of their mission and work. And thank you again to everyone in the Sutter Health family who continues to volunteer, fundraise and offer their skills for our efforts in helping Haiti.
We learned today that the hospital is two hours west of the Haitian capital of Port-au-Prince and has been flooded with patients seeking refuge. Before the earthquake, the hospital had 150 beds. After the quake, the number of patients seeking care surged to 300.
Sunday, January 24, 2010
Sutter Health’s surgical team has now gone two full days without an amputation. The newly donated equipment and anesthesia from our network and others are allowing the volunteers to perform surgeries equivalent to modern standards. They’re saving the limbs of Haiti earthquake victims.
At last report, the team performed over 20 surgeries today in two operating rooms.
Working with surgical colleagues from Mass General Hospital at Harvard and a local Haitian physician, Surgical Tech Isaias Camacho, R.N. (above at right) from Sutter-affiliated California Pacific Medical Group, performed an external fixation on a broken leg.
Dr. John Donovan (above at right), anesthesiologist from Sutter’s Alta Bates Summit Medical Center, works with a Mass General Hospital at Harvard team to perform another successful surgery that preserves a patient’s leg.
At 5:30 p.m. Haiti time, Dr. Donovan wrote, “Yes, we are still operating. Need to get back to work. We are using teams of surgeons and anesthesiologists to round on post ops and do dressing changes. We are almost as busy on the wards as in the operating rooms.”
Dr. Steve Lockhart (above center), anesthesiologist and chief medical officer for Sutter's East Bay region, works with the team to care for a child following an operation.
From Toni Brayer, M.D., Chief Medical Officer Sutter Health West Bay Region, Leader for Sutter Health's Help for Haiti
I also heard from Dr. Barry Rose, a Sutter-affiliated California Pacific Medical Center anesthesiologist and Haiti volunteer with Operation Rainbow. After a week on the ground, he is discouraged with the lack of coordination and lack of security for the teams that need to go away from the medical area to help patients in the surrounding communities.
Dr. Rose reports, “It’s a massive logistics, infrastructure and security problem. The scope of the damage is big, so we need to get out into the field, but the teams cannot be sent out without very serious security. Instead, projects spring up for surgical and continuing care of the patients that have some power and safety. Our efforts are hugely centered around the church structures—like after Hurricane Katrina. This is why I went where I did (on the Dominican Republic border), to be able to do as much actual surgical and work as possible, which we have done. We’re also helping to build an ongoing avenue for care—a difficult process and something that will take time.”
Report from Sutter team in Haiti -- From Toni Brayer, M.D., Chief Medical Officer Sutter Health West Bay Region, Leader for Sutter Health's Help for HaitiSunday morning, after the intermittent electricity came on, the Sutter Health surgical relief team was hard at work fixing a complex fracture. Now that they have equipment and pins, they can repair serious injuries previously untreated, and save the patient’s limb. Our team reports they are staying in safe housing (see photo) with good security and intermittent electricity. Communication is difficult, but as they get a break, we will hope for more on-the-ground news.
Saturday, January 23, 2010
Lead Sutter Helping Haiti
Sutter Health’s surgical team deployed to Port-au-Prince after a mad scramble to get necessary documents filed with the State Department, paperwork filed with HR and travel immunizations completed. Before leaving for Haiti, the team also rounded up vital medical supplies and equipment and loaded them into suitcases, which had to meet strict weight limits.
Despite delays at San Francisco International airport, the team departed as planned on two separate flights. The first group successfully made their connection in Atlanta, boarding a small private plane provided by Med Assets to transport them to Haiti. They arrived in Port-au-Prince at 3 a.m. (Haiti time) on Friday. The second group will fly in from Fort Lauderdale and should arrive in Port-au-Prince on Saturday.
While flying to Atlanta, Dr. Stephen Lockhart, leader of the surgical team, happened to sit next to a representative from iStat. (They make small portable units for drawing blood at a patient’s bedside.)The two began talking, and Dr. Lockhart explained the team’s mission. That conversation prompted a generous offer from iStat. They would provide bedside units to Sutter Health’s team in Ft. Lauderdale to bring to Haiti. It was either a great stroke of luck or divine intervention, but we can now bring even more urgently needed equipment to Haiti’s earthquake victims.
The Sutter volunteer team is:
- Steve Lockhart, M.D., Chief Medical Officer Sutter Health East Bay Region
- John Donovan, M.D., Alta Bates Summit Medical Center
- Vernon Huang, M.D., Mills-Peninsula Health Services
- Susan Bailey, M.D., California Pacific Medical Center
- Taylor Smith, M.D., California Pacific Medical Center
- Scott Taylor, M.D., Alta Bates Summit Medical Center
- David Chang, M.D., Alta Bates Summit Medical Center
- Joan Chamberlain, R.N., Alta Bates Summit Medical Center
- Cassie Kinser, R.N., California Pacific Medical Group
- DJ Eadades, R.N., California Pacific Medical Group
- Isaias Camacho, R.N., California Pacific Medical Group
- Joanne Squire, R.N., California Pacific Medical Group
- Elizabeth Petruzzella, R.N., California Pacific Medical Group
- Christina Crane, R.N., California Pacific Medical Group
- Scott Callaghan, R.N., California Pacific Medical Group
- Georgette Kearsing, technology assessment coordinator, Sutter Health Support Services
- June Quinones, administrative secretary, Sutter Health Support Services
- Pat Shepherd, director, Value Analysis & Strategic Sourcing, Sutter Health Support Services
- Jim Reich, Accounting director, Sutter Health Support Services
- Carol Ohlmeyer, Disbursements supervisor, Sutter Health Support Services
- Katie Moracco, executive assistant, Sutter Health Support Services
- James Huston, director of Materials Management, Sutter Lakeside Hospital
- Don McMann, vice president of Materials Management, Mills-Peninsula Health Services
- Annelise Wirick, project support specialist, Sutter Health Support Services
- Veronica Barnett, project support specialist, Sutter Health Support Services