- As she had mentioned to me on the phone, there was no history on the patient’s file, or his name, age and address.
- His blood pressure was recorded as 90/60, abysmally low and his pulse was 110, fast and feeble. As I was reading her findings, she gave me further information about him.
- “He is a tough young man, because after sustaining all those wounds and losing all that blood, he drove all the way here and almost crashed outside our Casualty Department.
- He collapsed after bringing his car to a screeching halt. The poor askari was terrified and called us outside.”
“I have a young man here, who is in no condition to give me his medical history.” The panic in Dr Tabitha Chege’s voice was vibrating hard in my ears because she was our senior Casualty Officer and dealt mainly with serious emergencies. I was not sure what time it was and put my bedside light on and looked at my watch, which as usual I had placed under my pillow.
I noticed that it was 2.20am as I heard her continue: “He has multiple lacerations on his scalp, hands, forearms and shoulders, all bleeding badly. As a result, he has gone into severe surgical shock. He needs to be taken to the theatre immediately to close his wounds and stop the bleeding.”
Tabitha left me in no doubt that I was required in the hospital immediately. So I rushed to the hospital keeping within the speed limit.
When I saw the patient in the Accident & Emergency department, I realised that Tabitha’s telephonic description was accurate and was pleased to see she had started the necessary resuscitative measures on him. There was blood flowing in one arm and in the other arm, she had set up a saline drip.
LOW BLOOD PRESSURE
As she had mentioned to me on the phone, there was no history on the patient’s file, or his name, age and address. His blood pressure was recorded as 90/60, abysmally low and his pulse was 110, fast and feeble. As I was reading her findings, she gave me further information about him.
“He is a tough young man, because after sustaining all those wounds and losing all that blood, he drove all the way here and almost crashed outside our Casualty Department. He collapsed after bringing his car to a screeching halt. The poor askari was terrified and called us outside.”
All the wounds were properly documented though by Dr Chege. According to her, all the lacerations on the scalp were bone deep. After quickly assessing the general condition of the young man, I said to her. “You transfuse the blood as fast as you can. I can see blood oozing out of all the pressure dressings you have applied on the wounds.
“I will go to the theatre and see if one is free and also find an anaesthetist who is immediately available. We will open the wounds on the table and deal with them as required.”
Fortunately, both the theatre and anaesthetist were readily available and the patient was transferred from the A&E to the operating theatre directly. Dr Chege came with him and assisted me. Once we started suturing the lacerations and arrested the haemorrhage, the patient’s condition improved. Dr Muturi, the anaesthetist testified to that effect. “The pressure is going up and the pulse is slowing down and it is now of good volume.”
It took us three gruelling hours to suture all his wounds and as Tabitha and I came out of the theatre, we heard the birds chirping providing a welcome musical relief. Waiting outside was the A&E Sister with a middle aged couple.
“How is he?” The lady asked. Looking at the hesitation on my face, she understood and explained. “I am Rhoda, Walter’s mother and this is his father, Justus.”
“Walter went to the movie in his dad’s car and we got very worried when he did not return home by midnight and did not phone us either. So I repeatedly rang him on his mobile and panicked when we did not get a reply. We started ringing police stations and hospitals. After many false starts, when we rang here we were put through to Sister Ng’ang’a and discovered that a young man replying to Walter’s description had indeed arrived at the A&E and was in the operating theatre. So here we are to find out how our son is.”
Convinced of their bona-fides, I replied. “We have no history but judging by his injuries, we think he was assaulted. He has got many wounds and has bled a lot but now that the bleeding has stopped, he should be alright.”
'REASON TO WORRY'
“Is there any reason to worry?” The father asked.
“Yes, there is.” I replied candidly.” That is why we are sending him to the ICU for a couple of days. He needs close monitoring and when his parameters are normal, we will send him to the surgical ward.”
“If a private room is available, we would prefer him to go there.” The mother requested.
Everything went according to plan and Walter eventually went into a private room. It was after he was transferred that we managed to obtain his medical history.
“I was heading home in Karen after the movie when I was held up by a gang of carjackers just after I passed the Jamhuri Park gate,” he explained. “They were obviously after the car but I was determined not to give it to them. They assaulted me with a panga and cut me in various places on my head. In warding off their blows, I put my forearms up and sustained cuts there.”