A proud moment ; indeed a silver line in emergency care

[25/02, 20:25] Sheril: Good evening Venu Sir.. I just want take a moment to thank you for mentoring me and being a great teacher with a great vision. It was a privilege to train in Emergency Medicine under your leadership in Aster Mims, an institute with great calibre. I am a better physician today because of the seeds of wisdom that you've laid in our minds that has the potential to grow to greater heights. I am attaching below a narrative of the recent event that occurred in my institution . I think a lot of what I was able to do came from the wisdom instilled into me by my parents and mentors like you to take on the impossible and face them with courage and practicality.
[25/02, 20:25] Sheril: Memoirs of an eventful day: I am sure every member of our family has a story to tell about this day.I thought I ll pen down the events ( from my perspective) that unfolded on that fateful morning when our hospital witnessed an unforeseen disaster which by God's grace was reduced to a bearable one in terms of casualties and one that we were able to bounce back from to normalcy in less than a day, alhamdulillah!!
Being the person on the frontline dealing with medical emergencies , my instinctive reaction was to make sure that any one injured during the disaster would require my team's immediate assistance than anything else.
From my eyeview it all unfolded with our Electrician being rolled into the resuscitation bay by some workers and one of our staff saying he fell down. Our team rushed in to the bay like during any emergency and when I was scanning through his ABCs and talking to him , the first thing that caught my eyes were his singed hairs and he told me that he was propelled off from a electric blast while in the electrical room. He was in immense pain not able move both his upper limbs, with large open wounds to both upper limbs. I realised this was an electrical injury and we immediately got into business. That's when a staff came running in saying that everyone has been advised to evacuate the hospital , a fire is building up in the nearby building and that people were all running out.
My immediate reaction to my staff inside the resuscitation room was - " no one leaves this room until we ve stabilised this guy!!" . And so my team mustered the courage and told me , okay Sir, let's do it. The commotion outside was rising even further  as we were establishing iv lines , stopping his bleeding ,administering iv fluids and analgesics, splinting his fractured limbs and just as I got his monitor readings showing a heart rate of 50 , we heard a blast and the lights went out and it was pitch black....

I realised that things might be getting out of hand , so I sent one of  our staff to arrange for an ambulance and I told my team that if this guy requires definitive treatment , then he needs to shifted out. I immediately called up Alshifa ED team and told that I m coming in with an electric burns patient with orthopedic injuries and they concurred. In the mean while I told the rest of the team that I ll just step outside to guage the situation outside ( It was running in the back of my mind that these guys are in this room on my orders , I had to watch their back as well) .

When I stepped out of the ED it was utter chaos, I could see people running in all directions, patients in  trolleys and wheelchairs being pushed out by bystanders themselves . To be honest my immediate thoughts were centred on getting my patient in the resuscitation bay to a safe place , so I got hold of Eby brother and asked him to get me an ambulance at any cost. I ran back into the bay, only to find an empty room!! ..... I was shocked!  He was moved out without my orders... I started searching for this guy on the trolley amidst all the people and dust ... no where to be found.. After frantically searching for my patient and staff, one of them told me  that many trolleys were being pushed out of the hospital gate , perhaps he should be there.. And when I went out , some of the on lookers told me that  there was a huge crowd running out and in the process a patient on a trolley had been rolled out towards al shifa direction!!
I immediately grabbed one of my staff and asked the ambulance driver to take me towards al shifa.. He told me , it couldn't be possible that people would ve rolled the trolley that far..As we neared Alshifa, there were people pointing toward the hospital thinking that this was another ambulance coming in with an injured patient.. I asked if a trolley with a patient came this way, and they said yes ! A trolley was indeed  wheeled in this way to the Casualty in Al shifa!

I got off the ambulance in front of al shifa ED and asked the ambulance driver and my staff to go back to our hospital and see if any more injured patients needed to be brought in. I rushed in to the ED in Alshifa and was immediately relieved to see my long lost patient along with my staff and our Neurologist who had instinctively accompanied the patient to bring him to safety.
I realised that the Emergency Physician whom I had contacted was not at the scene because he was called in for an emergency intubation in the ICU. So I had to step in and told the Alshifa ED team that I am taking over and we have to stabilise this patient after which I then asked for emergency consults from the ortho and plastic surgery team, handed over the patient to them and started back towards our hospital. The traffic was blocked, so I got hold of a gentleman on a scooter and told him to drop me off at our hospital.

When I got back , I could see that the chaos in the hospital was continuing and hoards of ambulances had swarmed into the hospital premesis. I immediately called up our Neonatologist to ask if any ventilated patients required transfer and he told me that the respective hospitals were informed and their team was on the way. I told him that I ll Co ordinate their transfer from the ground. I then rang up our icu incharge to see if any critical patients needed immediate attention , and fortunately there wasnt even a single intubated/ ventilated patient in any of our ICUs ( cardiac/neurosurgery/MICU) which otherwise would ve required a whole of expertise, equipment and manpower to transport them safely from so many floor upstairs to a safe location with all the backup. Alhamdulillah!

After ensuring that there weren't any critical patients anywhere in the hospital requiring immediate attention after enquiring with our Neurologist, pediatricians , I shifted my attention to crowd control. 
I realised that in the aftermath , it was actually the onlooking crowd that had come in who were creating all the unnecessary commotion by hindering the traffic of ambulances. I looked around for our security personell but no where to be found. A group of police officers near the drivers room caught my attention and I ran to them and requested the officer in charge to cordone the sides with police line tapes so that the incoming crowd can be controlled and they immediately concurred with the idea and started working on it.

With no electricity, oxygen, communication and the chaos in the first couple of hours, it was  futile to keep our emergency dept open to render care. But our staff and doctors were there in the dept ready  all the while to take up and atleast stabilise any emergency patient that came in, but fortunately we dint get any except for the first patient and we were up and running as usual by 5 pm with the exception of support services like lab and xray etc.

A lot of unnecessary evacuations were taking place of stable patients by patient bystanders themselves from wards and rooms which was totally out of any one's control and I think it wasn't authorised by any of the hospital staff. I suppose that is something that's beyond anyone's control, people trying to run for their lives I mean.

I appreciate the untiring efforts of all our hospital staff from all departments to help our patients and in putting out the fire.My big salute to Seethi Sir who emerged a true leader, he was there in the front yard just after the incident trying to coordinate everything and making announcements using ambulance mics despite the  havoc. And to all the doctors who pitched in during the accident especially the ones that caught my eye like Jayachandran Sir, Bineesh Sir , Dipu Sir and  even Jassim sir who used his own vehicle to transport his sick pediatric patients to nearby hospitals.

  We need to take lessons from this incident which teaches us that disaster can strike us at any point of time and perhaps there are things that we can improve upon that can help us be better prepared in adversities. And our unity during these times brings out the best in us and it was a tremendously appreciable job by all of us.

And all respect and standing ovation goes to our patron Rasheed Sir who rose to the occasion like iron man to bring the institution back to  perfect normalcy within just under 12 hours.. Mashah Allah!
[25/02, 20:30] Sheril: Thank you Venu Sir, you'll always be on the top of my 'best teachers list' !!
[25/02, 23:21] Venu ,Emergeny Medicine: Sheril, I am proud of you, You did an extremely commendable job. You saved one lives, otherwise, could have been died. And your approach to the whole event is so scientific and meticulous. I am fortunate, to get an opportunity to guide a person like you in residency. Keep it up and God may bless. You can do many, I am seeing your twinkling in the hight as a beautiful star... As an Angel.
I was so upset in the past few months, about the recent happenings in Kerala and people are killing the life-saving speciality ruthlessly. I have a feeling of relief while seeing real EPs like you. I am afraid that what will be future of EM in Kerala? As authorities are hunting excellent life savers blindly. This part of country losing all good and committed gems of doctors. For me you are awesome, and a candle of light in the present darkness.
Miss you