Trauma Resuscitation and the Covid-19 Pandemic in South Africa

In this podcast, Roger Harris interviews Victoria Stephen about her experience as an emergency physician in a regional South African hospital.

Sadly, trauma resuscitation is a big part of working in Emergency Medicine in South Africa.  Blunt force assaults and stab wounds are regular presentations.

However, July 2021 was unlike anything Doctor Victoria Stephen had ever experienced.

In July, South Africa was deep into its' third wave of Covid-19 infections. Vaccination rates were low and there was a huge burden of Covid patients in the Emergency Department. The ICU was completely overwhelmed, making this by far the worst of the pandemic that they had seen to date.

To compound this, piped oxygen levels were running desperately low. The hospital relied on daily oxygen deliveries to keep Covid patients alive.

Moreover, to add to the challenge, political unrest broke out and quickly escalated to riots with extreme violence across South Africa.

At the time the violence erupted, Tori had over 120 Covid patients in the hospital. Added to this the Trauma resuscitation was managing approximately 34 patients with gunshot wounds per day. With just four doctors working at night and six doctors working during the day, Tori’s team scrambled to manage an overwhelming number of high acuity patients.

For the first time in her career, Tori found herself frightened for her safety.

Having grown up in South Africa, Tori was no stranger to avoiding danger but this felt very out of control.

The thought of managing a busy emergency department inundated with trauma patients in the middle of the covid pandemic is frightening enough for most of us, but to do so in such a resource-limited environment with so few nurses and doctors is truly incredible. Tori believes Emergency Medicine training in South Africa prepares the team to function under such pressure. She believes that the team knows that the lack of resources means they must all pull together. Their training is diverse enough that they have the mental and clinical skills to step up and of course as an ultrasound geek Tori adds that EFAST scanning has a big role to play.

Tori is a humble but inspirational clinician on the frontline of providing care in a volatile environment and she believes we can all learn something from her experience. Tune in to a compelling conversation with one of our favourites.

Trauma Resuscitation and the Covid-19 Pandemic in South Africa

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