It was pretty ugly. EMS patched in early for an unresponsive pedestrian stuck. Severe facial trauma, unable to intubate in the field. We prepped for a difficult airway, breaking out the trach kit and a couple other serious-looking airway toys that I've never seen used. Patient rolled in a few minutes later, face covered in blood. The resident managed to tube her on the second attempt, fixing one problem before moving on to multiple others. Examination revealed multiple lacs and abrasions and an open tib fib fracture. The blood in the foley bag wasn't a good sign, either.
After bringing the kid over to CT, I watched as the trauma surgeons identified multiple rib fractures, a ruptured bladder, a splenic laceration and a couple small bleeds in the brain. Confident at least that she would survive, they predicted an extremely long and difficult recovery.
I walked past the crowd of friends and family that had gathered in the waiting room on my way out for the night. While the kid lay in an ICU bed hooked up to a ventilator, the jackass who put her there was still roaming free.
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