Placement day 1

These posts are probably come later than written and clusters due to the lack of wifi here. Today was my second day in Thailand and my first at the hospital on my placement. I was in the Emergency room, where I'll be for the rest of the week. It's striking how different it is here to back home. It was much smaller than I expected, a&e back home is massive, in the Royal Berkshire Hospital, the Royal Sussex County Hospital and the John Radcliffe in Oxford, all of which I'm relatively familiar with, the departments have multiple assessment rooms, waiting rooms and beds, which are almost always full. However here the department is much smaller. There is just one waiting area with a triage area to the side of the room, there is then the 'treatment area' consisting of a trauma area and a couple of beds to the other side, which seems to be for resting patients and patients requiring medication as an example. There is also a couple of doctors desks in the main treatment area, where the doctor comes and speaks with some of the patients before going onto further treatment. Even with the difference in size, the department was actually much quieter than we see at home, and much slower in pace than I was expecting. Despite this I managed to see quite a few different treatments. There was a lot of treating of wounds, and replacing of dressings. Most of this was fairly similar to some of the first aid duties that I've done with the red cross, but it was interesting to see the cultural differences in terms of dealing with that kind of injury. I saw other minor procedures also, such as the removal of stitches, insertion of an IV Line. These were mostly done by the nurses. The more interesting procedures were performed by the doctors. I saw a cut which had gotten infected, the entire area was swollen and the wound was filled with pus. I watched the doctor numb the area, using a local anaesthetic (this amused me as it was the same anaesthetic as in the numbing cream I use for my piercings back home), and then go on to open the wound further, draining away all of pus from inside the wound. There was also a suturing today, performed by a doctor, and a dislocated shoulder. The dislocation was probably one of the most interesting for me. I had a patient at my last first aid event back in England, who had dislocated his shoulder. He was treated by a combination of paracetamol, then later morphine and entonox administered by the paramedic called, before being taken to hospital. At this point I hadn't seen before how a dislocation is actually fixed clinically, so this patient was particularly interesting. The doctors were great and explained exactly what was happening to me. He'd initially gone to radiology to confirm the diagnosis of a dislocation and to check that there wasn't also any fractures. He was then given through a line a painkiller and some Valium, which works as a sedative, relaxing the muscle and facilitating relocation. I then watched the medical team manipulate the shoulder back into place by raising the arm. This seemed to relieve the pain the patient was experiencing. But he would have needed to return to radiology  to confirm that the relocation had been successful, and no new fractures had been obtained in the process. 

Anyway today was a half day, and I spent my afternoon visiting a temple on the top if a mountain. It was so beautiful, everything was covered in gold, and it had the most beautiful views over Chiang Mai, which is amazing, and massive in that it sprawls right across the landscape and into the horizon. Whilst there we got blessed by a Buddhist monk. We paid 20 Baht for a small medical box, to give to the monk as an offering. In return he said a chant, and splashed us with holy water. We then got given cotton bracelets, which are meant to give good luck. I also got the opportunity to take my first touristy, scenic shots of the holiday, which made me immensely happy! 

Exciting to see what tomorrow will bring!!

XOX