List of Medical Stuff one Needs in an Emergency

List of Medical Stuff one Needs in an Emergency

Things are not good as it is, and I wake up exactly 8 hours after a good sleep without bad dreams.

Nothing else to do, this is a way to ease my pent up anger of incarceration.

No anxiety at all!

But I must thank late Professor Senake Bibile, who was probably assassinated by CIA cohorts and Drug conglomerate of America.

This is dedicated to him.

Having said that, I have met bizarre medical personnel in Ceylon, UK and New Zealand where I have worked for considerable length of time and finally settle downed as a teacher and a research pathologist.

I used to say, I can run any hospital with minimum of facilities and of course, I did not have many when I was managing a D.M.O station with Cholera epidemic in this country.

My memory is failing and I start with a incident in a private nursing home in Negambo.

I had an 84 four year old male admitted to this nursing hospital for last rights by his relations.

I had a good technician who was a navel officer with whom I worked during 1989 in Digana village (IMMI) where the 15 or bodies and body parts scattered DJV guys/ girls dumped by our army, then active.

I did have a camera (as a pathologist I photograph some cases for posterity) but never ventured into hysterical photo record but the local journalists took some photographs and they were the first to appear in daily papers.

I told my private technician (he was not employed to save money) to make a blood film (I generally have a look at them after my clinical rounds) and look at it in detail.

He came running to me to report malaria and I told him not a surprise he had hepatosplenomegaly.

My in depth examination revealed even malaria gametes.

Caveat was he had appendicitis in addition.

 

I went and told the owner of the the institution for approval of intravenous chloroquine which I had to purchase from a local pharmacy.

We did not keep a stock and it has cardiac-suppressant effects.

With a ECG monitor standing by, I infused first the antibiotics (we have decided not to operate him immediately) and then the chloroquine slowly.

To my surprise he woke up from his slumber (he had thought he is going to die) and I asked him what he wants me to do.

He said he wish to go home immediately (to write his will or something to that effect).

I said nothing doing for 3 weeks (good for our hospital account) and I will tell him when.

Then I told him his kith and kin wished him dead already and not to trust them when they visit him.

furthermore, pretend you are in deep sleep (coma to be precise) and listen to them to confirm my above affirmations.

Malaria gone and primaquine (double dose) given to prevent relapse, he was by tenth day full of spirit and his ruptured appendix was forming into an abscess walled off (fat guy with lot of omental fat to ward of septicaemia) by the antibiotic treatment.

If my memory was right I gave a single dose of chloramphenicol which was followed by Rocephin IV.

On a similar note on malaria I diagnosed a malaria case in New Zealand clinically and asked the chief technician blood (malaria) film.

He said no malaria in New Zealand (I did not tell him the patient is a visitor from Malaysia).

I took a bet for a large chocolate slab and won it but we shared the spoils in good spirit.

He was the best technician I have ever worked with in my life.

In a similar case a patient was brought in moribund state (after writing his will) with a rollicking double pneumonia.

We treated him with Rocephin and he started recovering but my basal tests included Serum typhoid antibody titre.

He had typhoid too (confirmed) and Rocehin was enough to cure both pneumonia and typhoid.

I am not sure typhoid causes pneuminia.

He had two doses of chloramphenicol IV.

Mind you chloramphenicol is now banned in Ceylon.

 

In a lighter note all my engineer friends (only one girl) who did the Mahaweli Project including surveying came to me within 9 to 12 months with malaria.

The symptoms were variable (like Dengue) in addition to fever (by the way, not typical of malaria in textbooks).

I had eight Cesarean babies dying in my first month of internship.

We did not have a bacteriology unit and sent all blood and stool sample to Colombo confirmed typhoid epidemic in the hospital.

Thankfully midwife feeding the babies was a typhoid carrier, including few other nurses.

 

Closed the Unit and send the acting consultant guy back to base in Colombo.

I reported to the DHS that he was not in base on duty and was recuperating in Colombo.

MS was also transferred.

These were the times when Public Service Commission had teeth without political intervention.

Coming to my list.

My List

1. Saline and Dextrose saline

2. Blood.

3. Hyperimmune serum

4. Morphine

5. Frusemde and simple oral diuretics

6. Oxygen cylinder with mask to make 20-30% oxygen saturation.

7. Prednisolone

8. Isoprenaline with ventolin nebulizer

9. Insulin preferably with an insulin pump

10. Thyroxin

11. ECG

12. X-Ray

13. Emergency Blood film (malaria, ureamia, liver failure, anaemia, leukaemia and even metastatic cancer)

14. Blood sample for basic investigations virology not included.

15. Blood Pressure apparatus and appropriate treatment.

16 to 20 is optional depending on the initial cues.

That include, cholera, typhoid, hepatitis and now Coronavirus testing kit.