Tuesday, July 29, 2008

Living After Midnight

Mondays are always our busiest days, but yesterday was surprisingly manageable.  My assignment changed three times in my first five minutes, and I ended up working trauma and a hallway team for the first four hours.  With the exception of a slightly odd 61 year old female with shortness of breath who kept talking about burning her bra and creepily pseudo-flirting with me, and the task of finding a patient who had been lost somewhere between the ED, ultrasound, dialysis and her bed assignment on the floors, it was a quiet opening to the night.

At 7:30 I moved to our fast track area, which is staffed by a PA or APRN and a tech.  Normally I'm not a huge fan, as our job back there mostly involves computer and paperwork, but I managed to bandage a few wounds and remove three sutures placed just next to a patient's eye (I love trauma, and don't have any trouble with cracked chests or stomach evisceration, but eyes are the one thing that make me squeamish).  I had a great PA to work with, and unlike every other time I've worked back there and had to stay late to close up, we didn't have a single patient after 10:45.

With no patients in the drunk tank (again, a pleasant surprise) where I was assigned for my last four hours, I moved out to triage at midnight.  Around 1:30 we received a call about a MVC a few towns away.  Two patients came in, and I moved over to the trauma room.  The first had a probable tib fib fracture but otherwise looked alright.  I helped get him on the monitor and ran bloods to the lab as the passenger rolled in, and by the time I got back I helped start up our third trauma in 30 minutes; a drunk assault victim who had been hit in the head with a baseball bat and ended up getting intubated.  Meanwhile, the driver was getting his hip popped back into place, but during the conscious sedation lost his respiratory drive.  I got to bag him during two unsuccessful attempts at intubation before anesthesia came down to get the tube in.  As we were working on the driver, the passenger came back from CT with a newly-discovered head bleed and aortic dissection.

Once everything calmed down, I returned to triage and got gassed by the fumes of the floor waxing while I drew labs on patients still waiting to be seen.  Right before I left for the night, a patch came in for an 18 year old GSW coming in, and as I walked out to head home, the ambulance flew past me on its way in.

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