Saturday, December 8, 2007

Good thing they’re unconscious... mostly

On my surgery rotation we take Trauma Call! This means we carry a Trauma Pager. When the trauma pager goes off there is a text page to read that is an encrypted message like “level I 25 M GSW Abd SBP <90 GCS 8 EMS 3 min out, trauma 5”

What that means, is that a 25 year old man was shot in the belly and even though the ambulance is still 3 minuets away, you better get down to bed 5 in the trauma bay because this guy is unstable.

Imagine for a minute that you are a trauma patient:
You are in a car accident. The paramedics show up, they put you on a rock hard plastic board on your back and strap you down tight so that you can’t move. They also put a neck brace on you. They rush you off to the hospital. You’re rolled into the trauma bay and transferred onto the bed, though still on the plastic backboard. While the paramedics tell your story to the doctor, half a dozen people rush towards you in yellow gowns and purple gloves. The two at the foot of the bed start pulling your shoes and socks off and cutting off all of your cloths, including underwear. Simultaneously two others are poking you with needles on both arms to draw blood and start IV lines to give you fluids; others are sticking plastic EKG leads on your chest, a blood pressure cuff on your arm, and a pulse/oxygen monitor on your finger. Someone pushes on your belly. At the head of the bed a doctor yells at you “Open your eyes”, “What’s your name?” “do you know where you are?” “what’s the last thing you remember?”. While this doctor is firing questions at you he also shines a bright light directly into your eyes, and then looks in your ears, nose, and mouth. Next the group tilts you to one side for some reason, and shortly thereafter someone is yelling “X-RAY!” and they tilt you to the side again. The whole time people are talking back and forth “what’s his blood pressure?” “Can you get me a Foley kit?” “Good breath sounds bilaterally” “Did you get a temperature?” “He has good pulses” “Is his chest x-ray up yet?” “Does this guy have any medical problems or allergies?”

Finally they unstrap you from the plastic board, tilt you to one side, remove the board, and push on each of the bones down your spine. “Tell us where it hurts?” they yell. Next someone yells “finger up your bottom” just before you feel it happening. They roll you back onto your back and a catheter is shoved into your bladder. Someone else is moving a sonogram probe across your belly. If the chest x-ray the doc just examined looks bad you may get a slice between two of your ribs and a tube stuck in your chest. From there it’s to the CT scanner, the ICU, or the OR depending on your condition. Hopefully not long after your arrival someone gave you some pain medications and sedatives… I would sure hate to be wide-awake for all of that!

Moral of the story: don’t talk on your cell phone while you drive!

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