Bright ideas.

A weekend on call and some more frustration and anger, but this time at the EMRS (ambulance system). Last night in addition to the usual chest infections and malnutrion, I worked my way through 3 MVAs (with a total of 11 victims of varying severity and one very dead cow; black cows and no street lighting are a dangerous combination) and one stabbing to the abdomen. I'm no surgeon but I figured that bits of omentum hanging out wasn't a great idea and after consultation with some actual surgeons decided that it was probably better to stabilise and send to them rather than have a go here (although I'm thinking laparotomies aren't that different to c-sections, right?). The trouble was that having rung for the ambulance at 1am, when I rang at 3 to find out where it was they told me that there wouldn't be one until morning (6am). This was because out of the two ambulances we have, one "isn't fit" to drive the 3 hours to our referral hospital (although is fit to range around the dirt tracks in this area bringing in patients I then can't transfer out if it's needed) and the other had a broken light in the patient compartment so couldn't be used in the dark. My suggestion that they take a torch didn't go down well.