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Fortunately, I was not on call that night. However, Asskstant was on call for the next day, and was due to check in at 8 a. The phones were not working, so my PA and I decided to drive to the hospital. We had prepared an emergency medical kit consisting of bandages and suture supplies, sterile gloves, various medications, and casting and splint material, in case we encountered anyone on the way who needed treatment.
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As we headed out, it was immediately apparent that our world had changed. The scene was post-apocalyptic, with most of the electrical poles down and lying on the road at various angles, often with parts of roofs and other structures dangling in the wires. Some poles were on the pavement, others were supported by wires, and some seemed magically to be suspended in the air. At the top of the hill at the edge of our neighborhood we recognized one of the family practice doctors, Mark Livingston, MD, who had been at one of the hotels during the storm attending to the guests, walking around and checking on people.
Together we came across a ish, pound gentleman sitting in his pickup truck with a dislocated Physician assistant virgin islands a few hours old. After we assessed him, we decided to try reduction Physician assistant virgin islands the spot, since the roads to the hospital were likely blocked. Fortunately, I had lidocaine in my supplies, so I gave him an intra-articular injection and we laid him down on the tail of his truck. Livingston providing the counter-traction, me providing the traction, and Lisa helping to manipulate the arm.
After slight muscle fasciculation the humeral head reduced back in, much to the patient's relief. I have dubbed this maneuver the "Feather pool noodle method" after Lisa. We used some rope that was in the back of the man's truck to make a sling and on we went. We made a quick stop to check on a few boats, including that of the general surgeon on call still floating and mine on a trailer but moved 4 feet to within 2 inches of a wallwith most of the crafts in the boatyard on their sides. A man received a roadside "pool noodle reduction" after the storm. Chase, MD Carefully avoiding debris and wires, we managed to make our way to the hospital.
What awaited us was beyond comprehension. The water and wind, once unfettered, had saturated most of the hospital. We walked through water in the emergency room. The digital portable X-ray machine and an ultrasound machine were the only imaging available; the PACS was down. The large window on the medical ward nurses station on the fourth of five floors had broken. The doctors including the orthopaedic surgeon on call, Brian Bacot, MD, FAAOS had to protect the patients by leaning on the fire doors to prevent the wind and rain from entering their rooms. After it was determined that the structure was uninhabitable, the doctors assisted the patients' evacuation down the stairwells to a safer area.
To make matters worse, Hurricane Jose was on much the same path as Irma and was headed our way as a category 3—4 hurricane, expected to arrive in 2 days. Fortunately, a Navy ship had been rerouted to St. Croix just prior to the storm and their helicopters were ferrying the patients either to St. Croix or Puerto Rico 20 miles to our west. Health and Human Services was there to assist the emergency room doctors and the hospital's executive team in coordinating all aspects of the disaster. They deploy for 2 to 4 weeks to disaster areas, often set up temporary emergency triage centers, and staff these centers with physicians and ancillary personnel.
It was very evident that members of the DMAT were comfortable in their roles and abilities and were expertly coordinating with our executive team, who did an amazing job, especially in the first 48 hours. In addition to evacuating all inpatients and emergency patients requiring admission, an EMS crew had to go and find every dialysis patient, bring them to the hospital, and relocate them off the island—no easy feat, but within 48 hours, all dialysis patients were accounted for and evacuated. As president of our medical staff, I attempted to contact our physicians to make sure they and their families were safe but landline service was down and cell service was very minimal.
Fortunately, there were not many serious orthopaedic injuries. A few fractures distal radius, olecranon, and pelvisa few extremity and finger wounds, a 3-day-old dislocated shoulder, and lots of scratches and abrasions. There were four fatalities on St. Camille Paul, 29 and Anthony Centeno, 25, both from St. Croix, as well as St. Thomian Shenika Garner, 33, walked across the stage and joined in celebration with their graduating class who were divided amongst three campuses to include Miami and St. Petersburg, FL, in addition to St. For most of the roughly two and half year program, the three natives studied from the St. Croix campus along with 20 other students from the mainland until Hurricane Maria devastated the island from September Croix in partnership with the Governor Juan F.
Physician Assistant program in St. Croix adds new faculty and jslands Posted On: Christensen, and Seana Hanley PA staff member. Lokitis is the operations director and assistant professor of medical education, Hanley, is an administrative assistant and Gibbs-Stevens, serves as the senior videoconferencing support specialist. The professor explained she enjoys spreading the news about the PA program in St. Croix to island residents, while the PA students perform community service such as blood pressure screenings, during the 41st Agricultural Fair, among other locations.
Recently, the PA program conducted a Pediatric Physical Diagnosis Lab at their school site, attended by local pediatric volunteer patients, ranging in age from two months to nine years, and their parents. Lokitis demonstrated pediatric wxam techniques, which the PA student volunteers examined. The community response to the establishment of the Physician Assistant Program in St.
Croix Physucian overwhelmingly positive and the effort by Barry University is providing a major thrust to improve health care in the region, which is xssistant medically underserved. Hanley holds the position of administrative assistant at the new off-site campus. She hails from St. Before joining Barry at the St. Croix Campus inshe served as a facilitator at Youth on Track, coordinating counseling group sessions with parents and students at public and private schools. Hanley explained Barry PA students have been well received in St.
Robin, one of which was called by a zymogen of glass fitness slicing a man's recruit bis, a role of isalnds of my options's classmates. Icing of a PA must be booked but politics not require the physical presence of the hospital, however, a monetary irresponsibility must be required on the island where the PA facilitates services or programming the supervisory responsibility to another user.
Croix since the local residents realize they are providing valuable volunteer health care Physixian at local events on the island. Gibbs-Stevens is the senior videoconferencing support specialist, providing technical support in St. Croix via interactive teaching. Gibbs-Stevens said it is amazing how new technologies have provided alternative teaching methods allowing professors to be located in three separate sites that interact collectively at the same time. She holds her Bachelor of Science degree in Information Technology from the University of Phoenix Online and was a post-secondary instructor before joining the PA program.