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“Excuse me ma’am, is there anywhere to eat at this hospital?” I asked the resident at Annotto Bay.  She chuckled and responded, “Yes, there is a tuck shop right around that corner.”  I thanked her, but in the back of my mind I had no idea what she was talking about.  After multiple conversations with Diane, our driver Everton, and finally just breaking down and following the signs to the ‘Tuck Shop,’ I am pleased to say that I now know where to purchase my snacks! Yes, a snack shop! Now, for a little history on the origin of a Tuck Shop brought to you by our neighborhood sponsor…Le Google – The term “tuck”, meaning food, is slang and probably originates from such phrases as “to tuck into a meal”.

                   

Along with being enlightened, we also managed to squeeze in some clinical experience.  We saw, literally, the CUTEST babies everrrrrrrrr in clinic this morning.  I joked with the mom’s while giving lots of advice on seborrheic dermatitis and breastfeeding.  Meanwhile, Wanda saw a patient with congenital syphillis!

                   

To wrap up our day, we saw a little girl who had stubbed her toe on a dresser and developed a painful abscess.  We performed an I&D in A&E with the help of her mother and the sweetest nurse ever.  I’m sure that little girl will thank us….not today….but some day…perhaps.

     

Signing off,

Wanda and Shanna (while sipping smoothies at the fruit and veggie bar and watching the waves hit the shoreline)

…until next time!

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First day in Jamaica and we are loving the people and the place. Can’t wait to go the hospital and meet the staff and all the children. Day 1 of an incredible journey so let’s get started!!  
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There is plenty of variety this week-gingivostomatitis, possible appy, scabies, and a nursemaid’s elbow. I was able to call an Orthopedist on his cell for a consult and follow up with a few patients from previous visits. For the possible appy, I made sure I had an updated contact number to follow the patient’s symptoms, arranged follow up, and provided  a surgery consult referral in case her symptoms worsened. There’s a better workflow between the nurses and myself now that we’re familiar with each other’s expectations and I certainly pitch in and vitalize my patients when triage gets backed up. I also feel more at ease with documentation, accessing records, ordering films, and selecting appropriate referral centers.   Unfortunately, this was a short week for me due to a viral illness (flu season), but I’m feeling much better now and ready to get back to work.
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My first week went better than expected. The first few days were a bit rough working with little guidance or orientation but I figured things out soon enough. Once you figure out the system at one site, it’s pretty similar to others, so I didn’t need much orienting afterwards. Surprisingly, the resources weren’t as limited as I had been preparing for. I ordered and reviewed chest radiographs within one shift, selected several different antibiotics from the formulary to treat cellulitis, made a timely referral for a urologic emergency, and there was an otoscope at every site. I saw ~50 patients-plenty of asthma, URIs, cellulitis, and fungal infections. The communication between the nurses and myself varied from site to site. Most of the time, I had to request to keep a steady flow of patients and not assume I needed scheduled breaks. Nurses triage adults and children so getting orders filled in a timely manner, urgent or not, varied day to day. I surprised to see how much autonomy the nurses took in caring for the asthmatics, treating them with duonebs and steroids for 1-1.5hrs before I every laid eyes on them. By the time I listened to the patients, their mild exacerbations had been cleared. The patients and their families seemed grateful to be evaluated by a pediatrician. I spent a lot of time educating patients on inhaler+spacer use, controller vs rescue inhalers, monitoring for dehydration signs, and SIDs precautions. We’ll see how next week goes…
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Ernie Sandona (left), biomedical engineer and Issa Trust Foundation volunteer, demonstrates some of the modern features of the state-of-the art ECG machine to Dr Vincent Riley, cardiologist.

Ernie Sandona (left), biomedical engineer and Issa Trust Foundation volunteer, demonstrates some of the modern features of the state-of-the art ECG machine to Dr Vincent Riley, cardiologist.

Reported by the Jamaica Gleaner Friday | November 25, 2016 | 12:00 AM
Over the past two weeks, the Issa Trust Foundation – founded as the non-profit arm of Couples Resorts in 2005 – has donated a total of $10.3 million in equipment and supplies to hospitals in St Mary, St Ann and Portland as well as the Savanna-la-Mar Hospital. Twenty autoclaves (valued at $3.4 million), which are medical electronic equipment that sterilise surgical instruments under high temperature and high pressure, were part of the donation, as well as a new Welch Allyn ECG machine valued at $580,000. A crucial element of donations made by the Issa Trust Foundation is the provision of training and maintenance. Ernie Sandona, a biomedical engineer from Michigan, United States, was on hand to conduct a training session to approximately 30 attendees at the Annotto Bay Conference Centre. His training focused on the proper use and maintenance of the equipment to ensure longevity.   A shipment of new cribs, mattresses, IV poles and baby scales, all donated by Direct Relief, a valued partner of the Issa Trust Foundation, was made to the St Ann’s Bay Hospital with a value of $1.9 million.
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