Our first patient.

     Sorry for the delay in posting.  We have been busy and this is the first time in several days that I have found enough bandwidth to load Facebook.  

     We had our first patient.  He was a sick older man who had a fever and three of the constellation of symptoms that gave him a diagnosis of Ebola suspect.  We dispatched our ambulance, picked him up and transferred him to the ETU.  After our triage we tucked him in overnight with antimalarials, antibiotics  and fluids pending the blood draw the next morning.  By noon, we got his blood test back and he was negative for Ebola.  Given his constellation of symptoms, I wonder about Dengue fever or pneumonia but we don't have X-rays or any blood tests besides Ebola and Malaria in the ETU.  He certainly was too sick to send home so we transferred him to the neighboring community hospital in Tappita.  

     Overall, it was an excellent opportunity to work out kinks and minor coordination issues.  Trying to learn little things like who calls the drivers, how we get the sprayers who clean the ambulance in full PPE back into the ETU to doff their PPE, etc.  I learned that, when I wear them for extended periods, the triple gloves that we wear in PPE are a little too small for my hands.  After one half hour in PPE, the fingers of my right hand were going numb from lack of circulation.  And of course you are not in a situation where you can just take off the gloves.  Many if not most of the health care workers who become infected with Ebola, for whom you can document a route, became infected during the removal of the PPE.  You just finish the rounds and make a note to get supply to get bigger gloves.  

     I am off to Monrovia today to attend one of the WHO meetings.  Not the most fun part of the job, but it is very important to 'show the flag' and to meet the main players.  Who knows, maybe I'll find better internet!