I’ve just started my 2nd ICU rotation and I think it’s going to be horrendous. Thre are only 3 interns and 2 upper levels for the entire month. I was on call yesterday and it sucked. Non-stop activity teh entire day and night. Some of it was for sick people, but some of it was just tedium. We had three admissions. One was a trauma, a 48 year old nurse on her way to work. She swerved to avoid hitting a deer and ended up with a head bleed, a broken left femur, left tibia and left fibula. She needed four units of blood at 10 pm, so my upper level and I put a central line in and got her set up. She did better after teh blood.
The other trauma patient I have was an unrestrained passenger in a jeep who is really messed up. He broke just about every bone in the front of his chest…both clavicles, his sternum, multiple ribs. His lungs are bruised and bleeding and he has chest tubes on both sides. He was on a ventilator, but continued to deteriorate. Now he is on a breathing machine known as an oscillator. It’s a machine that essentially causes you to ‘pant’. He is getting 240 breaths per minute with a small volume of air in each breath, about 50 milliliters (for comparison, one dose of nyquil from the little cup that comes with the bottle is about 30 milliliters).
Needless to say, he also is losing blood. To complicate things, his father is a Jehovah’s witness and does not believe in receiving blood products. His mother, however is not. Since the patient is not able to tell us what his wishes are, we need to go ahead and give him the blood and blood components that he needs. It is amazing that he is still living, our attending described his care as “heroic effort.” It will continue to be heroic, and if he recovers from this accident, it will truly be a testament to the ability of the human body to heal itself if given the right circumstances.