"Boom", there was a loud noise outside ER suddenly, it had been reported a traffic accident and was very close to where I work. While we were preparing to receive the casualty, the injured have already arrived in a few seconds later.
A man with huge amount of blood on his face came into the ER with assistances from his attendants and tottering towards the bed. Colleagues quickly connected oxygen to patient and sat up an intravenous access. After few minutes, patient’s conscious level decreased accompanied by convulsions and large amount of hematemesis. Watching the rising volume inside the suction bottle, and the floor was heavily stained by blood, I made a quick decision that this patient needed to be referred to other hospital with better facilities. We are at the border and what we have are very simple and limited. We have no capacity for surgery, and definitely not for neurosurgery, intensive care unit (ICU), and any kind of sophisticated radiological examinations which were crucial for this patient. The only way we can save his life is referring him to other hospital, where located more than hundred kilometers from us. However, the road condition is not good to drive and it is a 3 to 4 hours long drive on a bumpy road. Each referral is just like gambling with Grim Reaper.
Before referral, we must firstly stabilize patient’s vital signs, for his condition with severe blood loss, blood transfusion is necessary. Colleagues quickly sent a blood specimen to laboratory for blood grouping analysis and cross-match. Few minutes later, received a call from laboratory that blood bank did not have stock for his blood group. I asked: "Any O-negative blood?" Unfortunately, the last bag of O-negative has just used up. I asked my laboratory colleague again: "What can we do for this difficult situation?" He said the only way we can do is calling every single donor from the donor registration book and asked them to come back for urgent blood donation. I said: " Good idea, please go ahead, as soon as possible." He was very efficient to find a blood donor and started the blood donation promptly.
It was so nervous while waiting for the blood. In the laboratory, the donor’s blood slowly filled into the blood package, however in the ER, patient’s blood was losing tremendously. We had constantly to do suction to protect his airway and increase the infusion rate accordingly. I called laboratory every few minutes and asked about the progress of the blood donation. Our conversation was straightforward and simplified to "How’s the donation?" "Still donating!" "As soon as possible, please, I need blood! “ At that moment, I was a vampire, and eager to suck the donor’s blood and complete the blood donation as soon as possible.
Ambulances for referral have already been ready, and the long-awaited blood package was eventually arrived ER. The blood bag on my hand was warm, that was the temperature from donor for sure. For this immediate donation-transfusion practice, it would never been happened in my home country, Hong Kong, and I can hardly imagine this as well. I could not wait to start the blood transfusion and load the patient to ambulance. Just hope the blood transfusion can support him for such long journey.
Several hours later, I received a call from ambulance colleague that the patient has safely arrived hospital and his life was saved. This time, the gambling with Grim Reaper, vampire won fortunately.