McDoc

Just another Medical Humanities Blog

Update to Help Send McDoc to Haiti on a Medical Mission

Posted by mcdoc on February 10, 2010

The update that I have tonight is that I do not have an update to my previous post Help Send McDoc to Haiti on a Medical Mission.

The Boston Team meeting was canceled due to winter storm warning issued by the National Weather Service yesterday. This afternoon the winter storm warning was downgraded to a winter weather advisory. Our team leader will be announcing the new time, date and location once confirmed.

On a related note, today at our resident didactic conference I presented journal club [Journal club as fun as it sounds is not a club. Journal club is medical training jargon for an organized presentation reviewing an academic journal article in a group]. On the article Chiou-Tan FY, Bloodworth DM, Kass JS, Li X, Gavagan TF, Mattox K, Rintala DH. 2007. Physical medicine and rehabilitation conditions in the Astrodome Clinic after Hurricane Katrina. Am J Phys Med Rehabil. 86:762–769. Full text is here. It documents the demonstrated need for PM&R expertise in a mass-evacuation, disaster-relief situation. Every disaster is different. The disaster in Haiti is dominated by trauma with fractures and crush injuries in the thousands. Unfortunately, many of these injuries either acutely or then developed into cases requiring one or more amputation of one or more limb. Credible estimates exceed 2,000 amputations.

Amputation is half the battle to saving a patient’s life with unsalvageable limbs. Assuming an uncomplicated post-op recovery, amputation has grave consequences in terms of changing and limiting one’s occupational options, productivity, social role, social status, independence, freedom and self-esteem. This is doubly true in a developing country that lacks wealth, resources, technology and advocacy to enable or provide meaningful, ready employment for people with impairments.

A residual limb and the rest of the patient need early and comprehensive rehabilitation in order to prepare for a prosthesis, and to prevent complications. Foregoing rehabilitation is a recipe for disaster, opening the door to development of a weak, swollen, contracted residual limb with hypersensation, prone to pressure ulcers and unable to be fitted for, or to tolerate a prosthesis. Here‘s a good run-down of amputation rehab.

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