Tuesday, August 12, 2008

Phantom Trauma

Typical Monday last night: a full waiting room, stretchers lining the hallway, short on staffing, and plenty of minor traumas filling up our beds.  I worked in our chest pain unit for the first four hours of my shift, and then moved out to trauma for my last four, where my first patient was an obnoxious, loud, and uncooperative (surprise!) no helmet motorcyclist who crashed into a car and registered a BAC of .160 without even blowing into the straw.  Instead of the usual squirming, screaming and fighting associated with the dreaded rectal exam, he kept insisting that it simply wasn't necessary.  The resident stressed the importance of knowing if he was bleeding internally, to which the patient kept shouting, "I'll know!  I'll know!  I was in the military, I'll know!"  Later, he was afraid to enter the CT scanner.

With the trauma bay still full a couple hours later, the charge nurse came running in need of a bed right away.  Triage received a patch for a 17 year old female with slit wrists pulling up to our door.  Ripping a patient off the monitor, everyone scrambled to get ready: a fresh sheet was thrown on a bed, nurses grabbed intubation meds, the resident checked his airway kit, I had to bags of warmed lactated ringer's hanging and wheeled in the crash cart.  Within 60 seconds we had the room ready for a resuscitation and stood anxiously awaiting the patient.  After a couple minutes of waiting, we found out that the patient wasn't as serious as initially though, did not meet trauma criteria, and was brought to another area instead.  Ripping off our gowns, everyone shuffled out of the trauma bay, only to hear the page for yet another trauma, three minutes out.

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