just another day

So last night was supposed to be Krishneel's (one of the AE registrars) last night in Labasa.  He had gotten a transfer to another hospital so that he can be closer to his family who is in Suva.  To celebrate, we went out to one of only two nightlife options and I discovered this lovely Fijian specialty called Tribe Fusion, particularly lime flavored.  I would equate it to Smirnoff Ice but it is deeeelicious.

Unfortunately, since the doctors here in Fiji are subject to the whim of their government, Krishneel's transfer was temporarily canceled today (apprx 1 hour before his flight home!) so he still had to show up for work this week.  Who knows when they'll let him actually transfer?

Here's proof that I've actually been working:

20 year old Indo-Fijian male who was assaulted with a machete to the back of the neck (purposefully and he wouldn't say he did to piss the other person off).  Initial vital signs were normal and GCS 15, moving all extremities well.  It's difficult to appreciate on this photo but the cut is actually several centimeters deep and he had persistent oozing of bright red blood from the left lateral aspect of the laceration.  Oh and did I mention that he came from a small village apprx 1-1.5 hours away?  After sitting in the ER for about 5-10 min, he became unresponsive and his BP dropped to 85/68.  The entire sheet underneath him was blood-soaked.  We initiated fluid resuscitation with NS immediately while holding pressure over the area and consulted the surgical registrar who happened to be down in the ER anyways.  His BP responded well to 3L NS and but his HR remained tachycardic (strange that he wasn't tachycardic before hypotensive).  He clearly had some small arterial bleed deep inside the cut and I ended up holding pressure for about 2.5 hours during resuscitation before the bleeding stopped enough that the surgical registrar felt that he could throw a few simple interrupted sutures over the left lateral aspect of the cut.  The patient was admitted for surgical exploration of the wound in the morning.