Sunday, August 28, 2016

August Volunteering

August has been a busy month! In addition to a pretty intense courseload with lots of studying to do, I've also been putting in a lot of volunteer time. I initially only intended on getting involved with a project started by Dr. Charles Zhang, a 3rd year EM resident at UMCNO, called Street Medicine New Orleans. However, when the flooding in Baton Rouge became disastrous, I drove to Baton Rouge and put some volunteer time in at the River Center, which is currently operating as a shelter for thousands of people displaced from their homes by the floods.

One of the four atria of the River Center 

The medical coverage for the shelter is being provided by a few separate groups working in conjunction. The first is the AL-1 and AL-3 Disaster Medical Assistance Teams, deployed from Alabama, who are comprised by doctors, nurses and paramedics. The US Public Health Service has contributed a team of doctors and nurses as well. Finally, state and federal funding has been put forward to have 24/7 ambulance coverage at the River Center by local ambulance services including East Baton Rouge EMS, Acadian Ambulance, and a few other smaller services.

When I arrived at the River Center on August 22nd, I found my way to the clinic that has been set up in a room off to the side of one of the atria and introduced myself.

The clinic at the River Center

I was quickly given a task of triaging patients, assessing medical complaints and vital signs, blood sugar, etc. Many people left their homes without their medications and without any means of managing chronic health problems like hypertension, asthma/COPD, epilepsy and diabetes. Many people come by asking to have their blood sugar checked, with quite a few of them extremely hyperglycemic. I started a few IVs, hung fluids and reported to the physician my findings for each patient that came to the triage desk.  I spent 8 hours at the River Center, from 5pm to midnight that night. Most of the patients who came by had minor issues- headaches, cold symptoms, though one woman had an exacerbation of her COPD. Anyone who needed more significant treatment than what the team at the River Center could offer was transported to the ED by ambulance.

On the 24th, I went out with Dr. Zhang on his SMNO walk. Along with a Tulane medical student, the director of NOPD's homeless outreach team, and an acupuncturist, we made rounds of encampments around New Orleans to check up on chronically homeless people, some of whom had been patients of Dr. Zhang's that he wanted to follow up on.
The SMNO team that night
From 8pm to midnight we met many different folks living in tents under overpasses around downtown New Orleans, and discussed their medical issues with them. We checked a few blood pressures and blood sugars, and Dr. Zhang counseled patients on following up at the homeless health clinic at the VA. The acupuncturist (pictured at left) provided some acupuncture for folks who complained of chronic pain. We met a group of homeless people who were outside drinking on a stoop, and talked to them about questions they had regarding foot pain, fungal infections and diabetes. Officer St. Roman, of NOPD homeless outreach, wrote a few letters for people to get appointments with a housing counselor. Overall it was a really fun night, and we made a few nice connections with chronically homeless patients who were extremely appreciative of the attention they received outside a hospital setting.

On the 25th I made my way back to Baton Rouge for another round of volunteering with the DMAT at the River Center. It was an even busier day as other shelters around Baton Rouge had been condensed into the one massive convention center shelter. Now, with a little more familiarity, I jumped right in to assessing patients and presenting them to the doctor on shift. I helped clean an elderly patient who had some mobility-based hygiene issues and was experiencing skin breakdown around his upper thighs, and then applied antibiotic ointment to the affected sites. The USPHS doctor advised him to return as often as necessary to avoid further skin breakdown.

At one point we were called by a Red Cross volunteer for an older gentleman who fell unconscious in another area of the river center. We ran over and found this man who had passed out and didn't recall the fall, with a large abrasion to his forehead. He told us he hadn't been drinking much water that day and smelled strongly of alcohol, so we placed a cervical collar, lifted him to a stretcher for transport to the hospital. I rode in with the Acadian crew as we took him to a nearby hospital.
Lady of the Lake hospital in Baton Rouge 
When we got back to the River Center, I checked back in with the medical team and returned to triaging patients. One of the walk-up patients was a fellow who hadn't had his antipsychotic medication since before the storms and was experiencing worsened schizophrenia symptoms. I counseled him on getting a transport to the hospital for a safe place to get his psych meds returned to therapeutic levels and he went by ambulance. As the night continued patients continued to arrive, but I had class early the next morning I had to leave.

 So that's been my volunteering for August! It's been a fun week or so of getting involved with different groups doing important public health and medical aid work! My favorite pharm related thing that happened was when a lady came by complaining of a gum abscess and the doctor prescribed her clindamycin, and I recalled Dr. Dery's refrain: "Clinda above the diaphragm, metra below!"