Papua New Guinea
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20-year-old survive from chest trauma

Richard Ginamoa, aged 20, sustained a deep chest laceration from a sharp object while making his way back to his remote Bush Mekeo village in the Guari Local Level Government of Kairuku District.

The injury was severe, resulting in a significant opening in the sternum that exposed his internal organs.

He was taken to the Akufa health centre where the staff promptly recognised the complexity of the case and determined that immediate referral to Port Moresby General Hospital was necessary.

The officer in charge contacted the St John Ambulance emergency operations centre on Thursday 17 August at 6:34 pm initiating the referral process.

The patient was in considerable distress, experiencing intense chest pain and struggling to breathe. The nursing team administered normal saline intravenously and closely monitored him as they transported him by boat downstream to the Apainapi Bridge.

Contact information was exchanged between the accompanying nurses, and ambulance dispatchers at the St John operations centre to ensure continuous communication during the journey.

Departing from the banks of Akufa River at 8:45 pm, the journey downstream was expected to be arduous, given the gravity of Richard's condition but that was the only way for Richard to have a fighting chance to live.

An ambulance crew, composed of Health Extension Officer Rachael Pyokol and ambulance officers Solomon William Jack and Vali Tau were dispatched from Port Moresby to wait at the Vainapa Bridge.

Upon arrival at Vanaipa, describing the condition of the patient, Solomon said, Richard was in distress and needed first aid and advanced pre-hospital care.

“He was transferred into the ambulance and was stabilised with a chest seal, oxygen support and other essential treatment,” he said.

Even though it was 3 a.m., throughout the journey, the SJA HEO sought advice from the St. John medical advice line, receiving further clinical guidance from a senior paramedic and an SJA specialist doctor.

One of the main challenges the team faced was dealing with hemothorax, a condition involving the accumulation of blood between the chest wall and the lung.

Administering critical care in the early hours of the morning, it took the team five hours to reach the national referral hospital, all the while carefully monitoring and managing Richard's condition.

During the journey from Vanaipa to the main road, the crew encountered a crisis as the oxygen supply dwindled.

Responding to their distress call, an SJA ambulance returning from an emergency in Tapini provided an additional oxygen cylinder upon meeting the crew at the Aigevaru main road junction.

Richard was taken to the PMGH emergency department where a seamless handover occurred and he went on to receive the help he needed.

Several days later, Solomon and Rachael visited Richard at PMGH, finding him in significantly improved spirits compared to their initial encounter on the riverbanks of Vanaipa.

Aunt Martha Ambros conveyed the family's profound gratitude for the actions of the Akufa health workers in promptly calling 111 and facilitating Richard's transfer.

“Mipela blo bush Mekeo we em longwei stret, na tu nogat road na sapos St John ino bin stap long Vanaipa Richard bai nonap stap laip so mipla tok tenk yu tru lo yupla na ol wokman meri blo hausik we helpim mipla stret,” she said.

"We come from the remote Bush Mekeo area, inaccessible by road. If St John hadn't reached us quickly, Richard would not have survived. We extend our heartfelt thanks to the health workers at Akufa, PMGH, and St John. Your support has made a significant difference in our lives."

Gilbert, Richard's father, who was in town for medical treatment, is now caring for his son alongside his sister as Richard receives treatment.