Today was one of the best days I have had so far and its not because I am on family medicine, it is because I have so much down time during this rotation that I get to spend a bunch of time in the ER just hanging out watching whats going on. Today we started at 8am, saw our patients, wrote our progress notes then rounded till about 11:30. After that, we were just waiting for admits so I headed down to the trauma bay in the ER. It was pretty slow at first. A little 3yo boy came in with his mom after being attacked by a cat in the backyard...and by the looks of him the cat won. I helped clean him up with saline and bandages [it was all superficial so no permanent damage]. As i was cleaning him up, the trauma pager went off about a airlift coming in. 20-somethin yo M low BP, bradycardic with multiple injuries after a failed BMX stunt. he overshot a 125ft jump...oh, and he had lit himself on fire before it [had a fire retardant suit on]. ETA 15 minutes.
i watched the ER team suit up in protective gear and down came the trauma residents and another 3rd year on her surg rotation. i went out with 2 surgeons, a trauma nurse and the med student to the helicopter to get the patient. it was very dramatic. the patient came out of the helicopter and fortunately, his BP had risen and he was talking. able to tell us his name and what happened. then the nurse asked him what he was doing and he said he was shooting a movie, she responded "oh good, so you werent doing this just for fun cause i first we just thought you were a huge idiot." the rest of the trauma followed that tone.
pt was transfused, got 2 chest tubes, and a ton of x rays. ended up having some ridiculous fractures including a pelvic fracture. he was not in good shape. he made sure to ask for his 'fucking morphine' and also made sure 'we took care of his dick because it better work after this.' at one point when things had slowed down a bit but he was still surrounded by people, he looked at the doctor who was hovering above him and said "hey, hey doctor, i need to tell you something. everyone kinda looked around waiting for him to cuse us out or start yelling...but instead he said, "i love you"
pt was taken to ICU, im sure ortho surg would be busy with him for a while.
during this trauma, shit hit the fan and 4 other MVAs came in 1 after the other. the next to come in was an 18yo guy who was hit by another driver who ran a red light. after quick look over, he was fine except for a ton of lacerations on his face. he had blood and stuff all over his face so the intern asked me to clean him up. i ended up spending a lot of time with this guy as i washed out his face lacs. i also helped him called his bro and mom to come to the hospital. his nose and cheek were pretty messed up so we called the OMFS [oral maxillary facial surgeon] to come stitch him up. i watched/ helped while the resident [ a dental resident actually] fixed up this guys face. he was in the trauma bay for the entire afternoon. and i felt good saying good-bye knowing i helped a lot in his case.
i didnt get as involved in the other MVAs that came in or the other BMX guy with a broken leg. all i can say is that ortho was just about in the trauma pod all afternoon because of all the fractures that were coming in.
it was around 7pm and my resident texted me telling me I could go home. but, i ended up staying in the ER anyways because another trauma was coming in. the residents were getting 'suited up' again and while they were waiting one guy looked over and me and say hey, can you staple? "uh, yeah i guess, i have done it in the OR a lot." ok cool, go to trauma 8, clean out the guys scalp lac and staple it a couple times. we're pretty swamped and could use the help..... well shit, i got some stuff together and went to trauma 8. i cleaned up the laceration and grabbed the resident to take a look before i did the stapling. "ok, looks good, just put a couple in." i was confused because we hadnt put in any lidocaine yet and he said we dont need it, to numb him up will hurt way worse than putting in the stables. just be quick and do it.... so i did. go ahead and add "stapling a guys head" onto my resume.
i loved my afternoon. i love the ER. this is pretty much the coolest specialty. this is def what i want to do on a regular basis :)
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