St. Emlyn´s - May 7, 2016 - By Robert Lloyd
"Last year, I was lucky enough to have a 3-month elective in South Africa. I split my time between New Somerset Hospital in Cape Town, and Khayelitsha District Hospital in the nearby township. It was the most educational experience of my career to date – here is my original blog on the experience.
My most valuable lesson from the Western Cape?
These are just the trauma statistics from my first night shift working in the staggeringly violent township of Khayelitsha– it honestly felt like working in a warzone.
Throughout that first set of weekend nights, I was overwhelmed by the environment. I was completely unprepared for the onslaught of young major trauma patients – it was unimaginable. Having never been exposed to anything even remotely comparable, an intense physiological and emotional reaction ensued. This was devastating to my performance.
Here are some of the effects of that I encountered:
- Tachycardia – severe palpitations
- Ringing in my ears (auditory exclusion)
- Negative, persecutory thoughts
- Decision paralysis, inability to prioritise tasks
- Loss of fine/complex motor skills (I was visibly shaking)
The environment, and my reaction to it, was intense. Though I’m sure anyone who works in EM, regardless of setting, will be able to relate to that frighteningly visceral sensation of being completely out of your depth.
On a daily basis in our specialty we must make decisions with massive implications on limited information, and perform time-critical interventions on rapidly deteriorating patients. We are an extreme specialty – the BASE jumpers of the medical community."
To perform well in an acutely stressful environment, you must have the right mindset.
