5 Times Healthcare Workers Needed To Improvise Care In Emergency Situations

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In emergency situations, healthcare providers are forced to improvise with basic everyday items

Although healthcare standards continue to improve, third-world nations, countries at war and populations at the edges of civilisation still lack cutting-edge medical tools, and doctors working in those environments are forced to be creative when faced with a medical emergency.

Here, we look at 5 instances where a healthcare provider added creativity to life-saving solutions.

1. In-flight emergency medicine

Professor Angus Wallace, a highly respected orthopaedic surgeon, was on board a flight to London when he was asked to tend to a 39-year-old woman whose right arm had swelled up after having fallen off a motorcycle on the way to the airport.

Diagnosing a simple fracture, he splinted the arm and returned to his seat.

Shortly after, her condition deteriorated – she was suffering from a pneumothorax caused by a broken rib.

With a scalpel from the flight medical kit, Wallace made an incision in her chest. He straightened and sterilised a coat hanger with some brandy from the refreshments cart, and guided one end of a plastic tubing into her chest and submerged the other end into a bottle of water – essentially crafting a makeshift underwater sealed drain.

Within ten minutes, air flowed out of her chest into the water, and the patient survived.

2. Improvising in extreme environments

Ben Cooper is a camp medic at the Union Glacier Camp, a remote hospital located in Chile with an average temperature of -49 Celsius where the extreme cold makes plastic equipment brittle and freezes vital medications.

In one incident, a climber had fallen into a crevasse while investigating a new route in the mountains and ruptured a muscle in his chest in addition to a broken leg.

“I took out an ambulance splint that we use every day in the UK and it just froze and shattered into 25 pieces,” Cooper said.

Using a heat-proof stove board, he splinted the broken leg, secured it with duct tape from the handles of his ski poles and brought the victim back to camp to realign the fracture.

“In hospital you’d put a block under the knee to help align the bones, but we didn’t have any of that stuff so we used a large catering tin of peaches,” he added.

3. DIY medical equipment from everyday items

Emergency physician Kenneth Iserson was working in rural Ghana in 2010 when he had to tend to a three-year-old girl who was a victim of a road traffic accident. She was unconscious, but there was no CT scan to assess her head injury.

The team provided basic life support, but despite the availability of a “manual resuscitator” – an air-filled bag which could be pumped by hand – they did not have an endotracheal tube that suited a paediatric patient.

Improvising, they cut a thinner length of tubing from another medical equipment, but still needed to fit the tubing to the resuscitator.

“We took the nipple off (of a plastic baby bottle), cut a little hole in it and reversed it,” recalled Iserson. “It fitted perfectly on the resuscitator – then we were able to slide the tube in.”

A few days later, the child recovered, and was allowed to go home.

4. Low cost baby incubators

To save premature babies that were born into poverty, four graduate students, Jane Chen, Linus Liang, Naganand Murty and Rahul Panicker, designed a low-cost incubator – a sleeping bag with removable heating element made of phase-change material, which can maintain a desired temperature of 37 Celsius for up to six hours.

The sleeping bag incubator is durable and portable, and also encourages Kangaroo care which promotes skin-to-skin contact, unlike traditional incubators.

Their invention is donated to impoverished communities in need of incubators.

However, in environments where even such materials are inaccessible, Iserson improvised by using lightbulbs over cribs as incubators for premature babies.

5. Makeshift emergency nebuliser

Kurshid Guru, a robotic oncologic surgeon, was aboard a flight to the US when an asthmatic toddler suddenly became short of breath.

It was then realised that the two-year-old’s parents had mistakenly checked in his asthma medication.

Guru quickly constructed a makeshift nebulizer from plastic cups and a water bottle, and administered the asthma medication using the adult inhaler from the aircraft’s medical kit.

"I got a water cup and made a hole in the bottle and focused it to his face...told [the parents] to keep it there," Guru recounted. "Within about half an hour and two treatments he was sounding much better.

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