The other night on call, I was just about to stop foot out the door when I got a page from the operator. Double trauma en route by ground, ETA about 1 minute. I ran to the Trauma Bay with the cheif, barely had time to gown and dress when the first one rolled in. Unlike the last trauma I ‘ran’, I was the ONLY trauma resident, and the trauma attending had just arrived and was tending to the other patient who was much, much worse than mine.
Just like last time, the trauma began to run itself. I did an arterial puncture in the groin for stat blood work. She was intubated by the emergency medicine resident. Once her airway was stable, we rolled her and I examined her back, did a rectal exam, and rolled her back. This time I KNEW what to do without the attending hitting me on the shoulder asking what I wanted to do. It was time for X-Rays! After the xrays were done, I put in a foley catheter then we wheeled her down the hallway to the CT scanner. The process was pretty smooth. It could’ve run itself, but I was directive enough that each step went smoothly. The attending popped in and out and must have thought I was doing OK, because after we discussed what we wanted scanned, she said to me, “Are you alright?” “Yep,” I said. “OK, thanks buddy,” and she walked back out.
The couple was in a one car accident. She was wearing her seat belt, he was not. She suffered a dislocated jaw, which was reduced in the x-ray bay (I tried to reduce it, but the ENT resident finally got it.) and a broken ankle. That’s it. She was extubated and left the ICU in about 12 hours.
He, on the other hand, was not wearing his seat belt, and was ejected from the drivers seat. He suffered a broken neck, an open fracture on each upper and lower extremety, a ruptured spleen, a ruptured bladder, a tear of his perineum from his scrotum to his rectum. We took him to the OR, did a splenectomy, urology sewed up his bladder and perinium, with a drain for each area to help drain infection. Then, orthopedics came in and spent another 12 hours or so repairing all of his fractures. THey are far from done, and will need to take him back and forth to the OR for several more surgeries.
The lady’s comment about her boyfriend when we told her he was still in the operating room, “I hope this teaches him to wear his seat belt.” Mabye it will…if he survives.
The moral, ALWAYS WEAR YOUR SEATBELT!
AND your Helmet!