The reason I have titled this blog entry 'Volunteering' is nobody gets paid enough to deal with the following

Scorpions Cause Swine Flu. Well not according to health authorities, but last week we had a patient who presented with 'Scorpion Bite' symptoms for 2 days. Apparently he was bitten two days earlier and now had headache, fever, body ache in left arm and both legs and chest pain and coughing. The Scorpion landed on his hand, he flicked it off, and it bounced on his leg then ran away. For those not in the know, the Scorpions here are deadly if you don't get the anti venom. Symptoms of scorpion bite are massive pain at the bite site that spreads as the venom spreads eventually causing respiratory collapse. He was 'bitten' on the right hand, for those of you keeping up, note which arm had pain....see above...Anyway we assessed and treated for influenza and admitted the patient. But just when you thought this could not get worse, as his triage presenting complaint was 'Scorpion Bite' I had to explain to some of the health workers why we were treating for flu.

I am sure it's in the sharps container. As one of the checks for Morphine here the empty vials are counted back into the safe and handed back to pharmacy. It is over kill as the vials are counted out with two staff like in the rest of the world. Anyway I was giving a titrated morphine dose to a chest pain patient and after cannulating etc. I went to grab the vial from my trolley and it was not there. The trouble is if you lose the vial, or break one the Military Police become involved as the fear is you have obviously stolen it. I asked the other staff if they had returned it to the safe for me, however I had the keys. One of the staff said she may have dropped it in the sharps container with the Lasix vial. I am ready to call the police and start the paper work. Remember I have titrated the morphine so the syringe is with me. The morphine is not missing, only the empty vial. My colleague goes and gets the sharps container opener (yes we have one), empties it onto a bluey on a table and starts searching with a syringe she picked, ever so carefully, out of the pile. I had to walk away from this one.

PS the vial turned up in the rubbish bin next to the bed.

I'll just tip the yellow bin into the black bin...it's easier to carry that way. The title of this paragraph probably explains it all. But not quite. Yes the staff here responsible for House Keeping are responsible for emptying all the bins. I watch in awe as they tip the contents of the yellow contaminated waste bin into the general rubbish and tie it up together. Even though we make some effort to divide the rubbish into contaminated and uncontaminated waste. But here is a question that would make Carmel's hair stand on end. (no offense to you Carmel) How many mls of blood is safe to dispose of in general waste?

a) 0, body fluid is always considered contaminated

b) <20 a little bit can't hurt

c) <50 anything less than a syringe full

d) <500 if it's not yellow it's not infected

If you guessed <500 well you have been listening as what does it really matter as all the bins are tipped in together anyway. But policy does not say <500. If you guessed 0 then well done you have paid attention to your infection control lessons in Australia. But you are still wrong. The correct, policy supported answer, is <20 as a little bit won't hurt.

For God's sake put dirt in the wound. Basic home first aid for a 1 cm cut that bleeds. Shove dirt into it until the viscosity changes and it stops bleeding, and then charge to the hospital in a flat spin panic, past the triage desk and straight to the first doctor as this is bleeding still and obviously the most urgent imaginable condition that could present to an Emergency Department. Scream uncontrollably at the head nurse because no one appears to be taking you seriously. And after cleaning the dirt out of the wound, faint at the site of the 1cm cut. Well this was the role of the mother, the 18 year old daughter with the cut was cool, calm and embarrassed at the performance.

And finally the fast lane is in the middle.To maintain the 65,000 road deaths each year, and hence the Guinness Book Record, there has to be some driving conditions that are followed. The 'fast lane' in somewhere in the middle of the road. As you need a 'Turbo Lane'. Yes Rhian, Deano, Steve and Andrew there is somewhere for you on the road. The speed limit is 100kms but there is no enforcement and crashes are caused by Allah. Here in the hospital next to one of Dammam's widest roads, 4 marked lanes, anywhere up to 6 lanes of traffic you can hear the deep bellow of young Saudis proving their manhood from a V8.

Stay fit and healthy, I am here seeing why Calvary policies work, as I am doing the opposite and seeing why it does not work. Saudi is the negative that proves the positive.