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Handling Cases and Infections

Today we have scheduled 12 cases, but the cases we do change as the day progresses due to new patients as well as changes in priority.

This young woman [pictured at right] is typical. She is the fourth case of the day by our team (we are running 2 rooms). We are caring for several people who have undergone amputations that then became infected before they undergo final wound closure. As a result we are revising lots of these wounds, then will bring them back for washouts until clean enough to close.

The first case was a young girl with open wounds on her legs and arms. We are hopeful she will not lose a limb, but will need skin grafts when the wounds are ready.

Teamwork and Courage

The CRNA I am working with is intermittently tearful, and has been all morning. Caring for the girl was hard for her. I don't know what family members she lost, and language barriers and work environment prevent me from talking about this. However, her courage in coming to work to continue to care for these folks is amazing.

Today we gave the anesthesia team some more if the supplies we brought. They are very grateful for the gifts provided by Penn. Thank you for allowing us to provide these supplies.

We are integrating our supplies with the existing supply chain with rare exceptions. This is appropriate, especially given that we are the only team here operating.

Patient flow is much improved now that we know each other. It has been fun working towards integrating our team into this hospital. I would like to think that, while the beer helps, ultimately it is the skills of our surgeons that did the trick. That, plus their obvious compassion and efforts to treat everyone with respect.


This report was written by Michael Ashburn, MD, MPH, MBA, during his participation in Haitian relief efforts through Penn Medicine in coordination with Partners in Health.


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