Bright and early Monday morning, we headed to the burn center to deliver the toys we had bought to the kids. Their bright smiles and excitement wiped away all our exhaustion from traveling and got us ready to start our week. Paige started her rotation in the burn center. She started the morning with rounds given by the interns. Eventually Dr. Romero arrived and the surgeries began for the day. In total there were 5, and were all very quick and without any real problems. All the nurses and doctors in the Burn Center are experts at what they do, and this day was no exception. Three of the surgeries were simple cleanings, with the bandages removed the doctors used the grater on the burns to reesatblish circulation to the injured areas, otherwise the skin would continue to necrose and die. All the same it was a shock to see the graters being used on the children, but afterwards the burns looked much better with all the dead tissue removed and the previously bleached white skin looking healthy and pink. The other two cases were of more note. For the fourth case of the day, a little boy had been burned on both feet when he and his brother were playing with alcohol that came too close to a flame. The burns were very deep and Dr. Romero decided the boy needed skin grafts taken from his thighs to cover the deep burns. Once the grafting was done and the skin had been laid over the injured area, Dr. Romero spent time explaining how the graft would attach itself as skin to the injured area, that after being burned now had no ability to regrow. The 5th and final surgery was of a young girl with a 3rd degree burn that began right on her hairline and went back along her skull. The burn was about the size of a large egg. After seeing the wound for 5 seconds Dr. Romero immediately decided that the girl's surgery would need to wait until the following day, since he planned to rotate the girl's scalp so her hairline would be approximating normal, and move the area where she would regrow the skin back to the middle of her scalp, where eventually her hair would grow over it and hopefully wouldn't even be visible in time. Dr. Romero told Paige that she could help assist in sugeries and scrub in the next day now that she had some experience and had seen the generalities of what they did. Paige finished the day happy she had stayed some extra time and excited about the next day.
Rachel decided to take a break from her one-track mind of pediatrics and give adult medicine a chance, spending the day in the Adult ER. Excitingly enough, it happened to be an ortho trauma day. Upon her arrival, Rachel immediately saw x-rays of a patient with a broken femur and displaced elbow; the orthopaedic resident allowed Rachel to help put casts on the patient's arm and leg. During the casting process, Rachel explained to Dr. Vegara that she wanted to be an orthopaedist, so he made sure allow her to see all of the ortho trauma cases of the morning, including two patients with fractured ribs, a patient who had fallen and broken her hip, and a car crash victim with a fractured radius and zygomatic arch. In the process of impressing the residents and interns with her knowledge of ortho and radiology, Rachel met another orthopaedist named Dr. Middagh who also offered to include her in his interesting orthopaedic cases. Just when things looked like they were going to settle down, ambulances started bringing in patients from a several car pile up. Before Rachel left the ER, she saw 5 patients come, followed quickly by the press. Rachel took vitals for one patient, ran an EKG on another patient, then spent the rest of her morning trying to keep the press away from the patients. Finally, Rachel returned to the burn center to play with the kids and their sweet new toys.
On Tuesday morning, Paige returned to the burn center to continue her rotation. There were four cases that morning, with the little girl's surgery from the day before scheduled last since it was estimated to take approximately 3 hours. Dr. Romero had his intern, Miguel, and Paige scrub in on the first 2 surgeries, the 1st of which was a simple cleaning, and the second of which Paige assisted Miguel in setting a skin graft on a little boy's hand. As exciting as it was to scrub in, Paige couldn't wait for the final surgery of the day. Another volunteer was allowed to assist on the 3rd surgery, and continued to help during the 4th surgery, but 1 hr into the scalp rotation Dr. Romero left the OR after completing the hardest part of approximating the scalp borders, leaving only Miguel and the volunteer to suture up the remaining borders. Paige then scrubbed in and was able to suture up a side of the wound while Miguel continued on the other side. When Dr. Romero returned from leaving the OR to finish the surgery he was impressed with both sets of sutures and told Paige she had done very well. Even though the surgery ran into midafternoon, FAR after Paige's lunch, she left feeling ecstatic about scrubbing in to surgery that day and had high hopes of seeing more exciting things the next day.
Rachel bravely went back to the Adult ER, hoping to catch an orthopaedist and convince them to take her to surgery. Much to her dismay, the ER was very quiet, though she did get to remove stitches from a patient's hand and later help stitch a man's split lip. Just after finishing the stitches, Rachel turned around to see who she thought was the head of orthopaedic surgery and ran over to introduce herself. Dr. Undurraga was thrilled to hear that Rachel was interested in ortho, especially since his own daughter is specializing in ortho in Chile. He took Rachel up to the orthopaedic ER and sent her straight in to observe a surgery. The patient being operated on had been hit by a car and had broken several bones in his right arm and leg. After looking at the x-rays, Rachel saw that his radius, ulna, tibia, and fibula had been fractured (into several pieces) and were completely displaced. Rachel watched with excitement as the 4 orthopaedic surgeons hammered an hige rod into the patient's tibia and screwed metal plates into his raduis and ulna. The ortho OR sounded like a construction zone with drills and hammers constantly being used. Surrounded by the chaos, Rachel felt right at home.
As for Henry, the title of this blog is his advice to all of you. Henry has spent the past 2 days at home, feeling too sick to work at the hospital. Pobrecito.
Finally, continuing our "marathon training", we went to the Cristo this afternoon. For those of you who don't know, it is a statue of Christ way up on a hill outside the city. Unfortunately for us, the automatic lifts were broken and we ended up having to climb 1,429 steps to get to the top. On the bright side, Henry is now ready to enter an Iron Man race, Paige feels prepped for the 2012 Olympics, and Rachel has the lung capacity of Michael Phelps.
Rachel decided to take a break from her one-track mind of pediatrics and give adult medicine a chance, spending the day in the Adult ER. Excitingly enough, it happened to be an ortho trauma day. Upon her arrival, Rachel immediately saw x-rays of a patient with a broken femur and displaced elbow; the orthopaedic resident allowed Rachel to help put casts on the patient's arm and leg. During the casting process, Rachel explained to Dr. Vegara that she wanted to be an orthopaedist, so he made sure allow her to see all of the ortho trauma cases of the morning, including two patients with fractured ribs, a patient who had fallen and broken her hip, and a car crash victim with a fractured radius and zygomatic arch. In the process of impressing the residents and interns with her knowledge of ortho and radiology, Rachel met another orthopaedist named Dr. Middagh who also offered to include her in his interesting orthopaedic cases. Just when things looked like they were going to settle down, ambulances started bringing in patients from a several car pile up. Before Rachel left the ER, she saw 5 patients come, followed quickly by the press. Rachel took vitals for one patient, ran an EKG on another patient, then spent the rest of her morning trying to keep the press away from the patients. Finally, Rachel returned to the burn center to play with the kids and their sweet new toys.
On Tuesday morning, Paige returned to the burn center to continue her rotation. There were four cases that morning, with the little girl's surgery from the day before scheduled last since it was estimated to take approximately 3 hours. Dr. Romero had his intern, Miguel, and Paige scrub in on the first 2 surgeries, the 1st of which was a simple cleaning, and the second of which Paige assisted Miguel in setting a skin graft on a little boy's hand. As exciting as it was to scrub in, Paige couldn't wait for the final surgery of the day. Another volunteer was allowed to assist on the 3rd surgery, and continued to help during the 4th surgery, but 1 hr into the scalp rotation Dr. Romero left the OR after completing the hardest part of approximating the scalp borders, leaving only Miguel and the volunteer to suture up the remaining borders. Paige then scrubbed in and was able to suture up a side of the wound while Miguel continued on the other side. When Dr. Romero returned from leaving the OR to finish the surgery he was impressed with both sets of sutures and told Paige she had done very well. Even though the surgery ran into midafternoon, FAR after Paige's lunch, she left feeling ecstatic about scrubbing in to surgery that day and had high hopes of seeing more exciting things the next day.
Rachel bravely went back to the Adult ER, hoping to catch an orthopaedist and convince them to take her to surgery. Much to her dismay, the ER was very quiet, though she did get to remove stitches from a patient's hand and later help stitch a man's split lip. Just after finishing the stitches, Rachel turned around to see who she thought was the head of orthopaedic surgery and ran over to introduce herself. Dr. Undurraga was thrilled to hear that Rachel was interested in ortho, especially since his own daughter is specializing in ortho in Chile. He took Rachel up to the orthopaedic ER and sent her straight in to observe a surgery. The patient being operated on had been hit by a car and had broken several bones in his right arm and leg. After looking at the x-rays, Rachel saw that his radius, ulna, tibia, and fibula had been fractured (into several pieces) and were completely displaced. Rachel watched with excitement as the 4 orthopaedic surgeons hammered an hige rod into the patient's tibia and screwed metal plates into his raduis and ulna. The ortho OR sounded like a construction zone with drills and hammers constantly being used. Surrounded by the chaos, Rachel felt right at home.
As for Henry, the title of this blog is his advice to all of you. Henry has spent the past 2 days at home, feeling too sick to work at the hospital. Pobrecito.
Finally, continuing our "marathon training", we went to the Cristo this afternoon. For those of you who don't know, it is a statue of Christ way up on a hill outside the city. Unfortunately for us, the automatic lifts were broken and we ended up having to climb 1,429 steps to get to the top. On the bright side, Henry is now ready to enter an Iron Man race, Paige feels prepped for the 2012 Olympics, and Rachel has the lung capacity of Michael Phelps.
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