Sunday was our first day off, and it was welcomed! Finally a day to see what we could find in Suva - unfortunately not much is open on Sundays, but it still proved to be a fun day of walking around the city.
Note to self:
Kind of an overcast day, great scenery though!
The bay in Suva
The bus dropping people off at town hall
Peace Garden across from Town Hall - people were all out enjoying their Sunday afternoon. People here are so kind - after seeing us walking by, they asked us to sit and join them, it's too bad we had just grabbed food from the restaurant below!
The only open place for lunch - looks like they were prepared for the crown by the pile of chicken!
A small beach area we found - so had the children! It was so fun watching them play - some things transcend all cultures and waves never seem to grow old!
I was spotted with the camera - they were enthralled with actually getting to see pictures of themselves right after I took it! So fun! Precious!
This little girl did not want to miss out on the fun...
This is the traditional dress of men on the island - the "skirt" is called a sulu - its funny because some have even been modernized to have cargo pockets!
The precious little girl soon realized I looked nothing like mom - so she got a little nervous as to where mom was! Too cute!
We stumbled upon the courthouse - beautiful. This played a large part in the coup from 2000 - which occured after the last time I was fortunate enough to visit this beautiful country.
This building was once the most magnificient hotel on the island - it is due to undergo a complete renovation to restore its former beauty. It was occupied for a while by the army, now it just stands waiting for a revamping!
A beautiful church that we saw.
Today was a holiday - which meant for the most part Suva was deserted, including the ED. Right at checkout we met this precious child. She was checked out as being a severe dehydration, febrile illness. Definitely febrile, but had only vomited 2 times with the onset of her symptoms yesterday. Story didn't quite fit. So, time to reexamine and reevaluate. This little girl had the most remarkable Kernig and Brudzinski's signs I have ever seen - it, unfortunately, was textbook. As we lifted her head off the bed, she arched her back in order to move with us - absolutely unable to move her neck, wincing as we lifter her legs towards her. We called medicine immediately regarding lumbar puncture and antibiotics - as this is standard to call and get ok on treatment. They wanted to hold off until the little girl came to the floor - a little difficult to agree with coming from what we are used to in treatment of suspected meningitis. But, they took her immediately. Dr. Miller has a video of the little girl's exam - hopefully we can upload it.
Another patient from the day - yes, we soon began asking about cough, weight loss, night sweats, or any recent interaction with suspected TB patients. Denied all the above, but the resident on shift told us it was not uncommon for people to deny those questions. For us, the chest xray was suggestive enough to have medicine take a look at her - they agreed.
This little girl was met at triage - all wrapped up like it was middle of December in Colorado. So, we stopped. She had some stridor, and her sat's were mid 80's at best from triage - she walked right to the back with me. While on nebs her sat's improved to mid 90's.
This just made me laugh - Dr. Miller at her makeshift desk filling out LBJ charts, and her iphone ready...in Fiji.
And the last patient of the day. The battle of aVR not won in Fiji. This woman was bradycardic on our arrival into the room - atropine given, being bagged as her spontaneous respirations had literally stopped as we laid eyes on her. Atropine immediately improved her alertness, respirations - so, epi drip started as it was there and quicker to prep. Hand titrated to effectiveness as there is only one IV pump in the department - currently running the heparin drip as medicine didn't agree with this as a STEMI equivalent - they felt it was more an NSTEMI - so, no streptokinase. Of note, while she was bradycardic, the question was raised about pacing the patient. Currently there are no options to transvenously or transcutaneously pace a patient. After hearing that, heparin was immediately hung for treatment.
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