Equipment provided by Project SAVE helps save Zambian cardiac patient's life

(Note: Project SAVE donated the oxygenator, electric hospital beds and ambu bags mentioned in this story.)

Hello to All…I am writing this entry from the U.S. We have been in the States for six weeks now and it is such a difference in the world of "high speed connections!" Here you have access to the world within seconds… such a difference from the world of "dial-up and outages and 'our system is down' that we experience when in Zambia. Well, now that I can...

I wanted to tell you about Ian….

Sal was in town and Geoffrey was on call… there was a knock at my door and Anna said, "There is an emergency, can you come." I immediately followed her to the clinic to find a 68-year-old white farmer lying in the bed with a concerned wife standing at his side, and a son at the foot of the bed. They were very eager to start telling me their story.

As I listened to his words, I observed the surroundings to find that Geoffrey had already attached the transformer to raise the head of the hospital bed, and then to the oxygen concentrator which he had already brought out of the supply room. "Good job, Geoffrey" I thought so far, but I was a little confused when I saw the wife squeezing an Ambu bag over her husband's face that had a nasal cannula in place but not in his nostrils.

As I looked closer I realized he was conscious and breathing on his own… so why the Ambu? This reminded me of a scenario in an ACLS class!!! Well, seems Ian had a history of high blood pressure and an episode of bronchitis in the past month. That morning at the breakfast table, his wife told me, "he went out a couple times where he stopped breathing" and had to be stimulated to "come to." 

They put him in the car and started to "speed" off toward Livingstone, about 35km, away to a private physician in town. Well, here in Zambia you can't "speed" anywhere because of all the bush roads but especially because of the crater-filled main road to town. After a half an hour of travel they decided to stop at Sons of Thunder Clinic for help. 

As I continued to ask questions and listen I slowly and calmly walked over to Ian's wife and took the Ambu bag out of her hand, checked the O2 concentrator and placed the cannula in his nose. During a brief break in the conversation I took vital signs and then proceeded to call Sal. 

After hearing the report and assessment of Ian's condition, Sal decided to head back to the clinic. While waiting for Sal, Geoffrey started an IV and we made Ian comfortable. 

He began to regain color and was able to answer questions. He even began to crack jokes, which I discovered was part of his sarcastic personality. Once Sal arrived, he dug out the monitor/defibrillator and the pads. 

Using the machine as a heart monitor, we were able to see a very rough picture of the heart rhythm. Sal diagnosed him as having an MI (heart attack), administered appropriate medication and started to prepare the Land Rover for transport into Livingstone. 

With the back of the Rover padded with a mattress and multiple pillows for propping, Sal and I transported Ian and his wife to the  private physician in town. After verbal and written reports were given, assistance to get Ian transferred to a patient room and placed on O2 again (we were unable to run O2 during transport) and multiple thank you's and goodbyes, we headed back to the clinic. 

After talking to the doctor the next day, we found out that Ian had been sent on a commercial airline to South Africa for continued treatment. 

Ian was our first cardiac patient and the first real EMS system in operation - the first time when we could actually see transfer of care to a higher level. It was a good feeling.       

Renee Marini
Sons of Thunder Clinic, Zambia