...It Pours

As the yin to Wednesday's yang, last night's shift saw the oddballs replaced with some pretty critical patients that started to arrive just as I tried to grab dinner.  

Topping the list was a major trauma: single passenger MVC rollover with ejection from the vehicle.  Bilateral open tib-fib fractures and a nasty forearm fracture.  While rolling the patient to examine the back, I attempted to stabilize the arm above and below the injury, but could still feel bone fragments shifting from within (cool experience, but sucked for the patient).  Difficult airway prompted an emergency page to anesthesia and the cracking open of a trach kit, but our ED attending managed to get the tube after the resident was unsuccessful (my second near miss of getting to see a trach in the past few months).  A nasty-looking scalp lac exposed the skull for all to see before being quickly closed with a staple gun.  Poor guy went straight from CT to the OR and eventually the ICU, where he'll probably remain for the foreseeable future.

As soon as we finished packaging the MVC for his trip upstairs, an elderly woman with a massive GI bleed was rushed into our critical care area.  Within minutes her stretcher was steeped in a pool of blood, resulting in opening of the O-neg fridge and a quick run up to the blood bank for type-specific.  Managed to get her upstairs as well before the string of three minor MVCs and one dropped cheerleader rolled in back to back.  

I eventually made it to dinner three hours later.