Night of Trauma
Last night was my most busy night of traumas as a resident (although I have seen much busier nights as a medical student in new orleans with 15+ activations in a night).
Everyone was smashed and had BALs that bought them a bed overnight. There was a lot of variety. One guy had a gash ripped out of his abdomen and torso, exposing his muscles, which was done by the claw end of a hammer. Another guy got drunk and fell onto the subway tracks, ending up with a periorbital flap with extension deep to his skull. 2 brothers came in whose faces were sliced open by a knife wielded by a crazy uncle. Another guy was hit in the head with an unknown object and had a big forehead hematoma.
There were also plenty of drunk injuries who weren't activated. One guy drank himself silly, fell and landed on his head then had a lot of neck pain. He already had neck surgery so I wonder whether he really did fracture his C-spine or have ligamentous injury. The official read wasn't up by the time I left.
The toughest guy to babysit was one of the inebriated guys who got mad at the surgeons suturing him and tried to hit them and when we tied down his arms, tried to pee on them. He got a lot of Ativan, around 8mg and plenty of Haldol to go with it. I tried waking him up when the alcohol should have cleared his system but the Benzos needed some time so he ended up being a sign out.
In between traumas I was seeing the other patients including what should have been fast track. One guy had a small cyst on his lower extremity that had been there for 5 years and it popped tonight and was a little bloody without any pus. He had no other complaints but felt this was an emergency. He was tough to take seriously.
The morning really sucked because the oncoming team did not see how busy our team was during the night. Instead they saw a full chart rack of surgical patients to be seen. The way our system is set up, the surgical patients and traumas are seen by the same team. Being inundated with trauma really slows things down. I think it would be better to have a resident assigned to the trauma room, who takes care of all the traumas and the other 2 residents could work their way through the slew of surgical patients.
Line of the night: "Why did you come in?" "I'm don't know. I'm not a fucking doctor!"
Everyone was smashed and had BALs that bought them a bed overnight. There was a lot of variety. One guy had a gash ripped out of his abdomen and torso, exposing his muscles, which was done by the claw end of a hammer. Another guy got drunk and fell onto the subway tracks, ending up with a periorbital flap with extension deep to his skull. 2 brothers came in whose faces were sliced open by a knife wielded by a crazy uncle. Another guy was hit in the head with an unknown object and had a big forehead hematoma.
There were also plenty of drunk injuries who weren't activated. One guy drank himself silly, fell and landed on his head then had a lot of neck pain. He already had neck surgery so I wonder whether he really did fracture his C-spine or have ligamentous injury. The official read wasn't up by the time I left.
The toughest guy to babysit was one of the inebriated guys who got mad at the surgeons suturing him and tried to hit them and when we tied down his arms, tried to pee on them. He got a lot of Ativan, around 8mg and plenty of Haldol to go with it. I tried waking him up when the alcohol should have cleared his system but the Benzos needed some time so he ended up being a sign out.
In between traumas I was seeing the other patients including what should have been fast track. One guy had a small cyst on his lower extremity that had been there for 5 years and it popped tonight and was a little bloody without any pus. He had no other complaints but felt this was an emergency. He was tough to take seriously.
The morning really sucked because the oncoming team did not see how busy our team was during the night. Instead they saw a full chart rack of surgical patients to be seen. The way our system is set up, the surgical patients and traumas are seen by the same team. Being inundated with trauma really slows things down. I think it would be better to have a resident assigned to the trauma room, who takes care of all the traumas and the other 2 residents could work their way through the slew of surgical patients.
Line of the night: "Why did you come in?" "I'm don't know. I'm not a fucking doctor!"
posted by Henry NYC @ 3:35 PM
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