Trauma

Going through the emergency department has exposed me to all sorts of patients I hadn't seen since medical school. As a medicine intern, I almost never see trauma patients, but they make up a core element of the emergency experience. A couple nights ago, we had two major traumas, victims of a high speed freeway chase. Upon hearing the arrival of these two patients, the emergency room sprung into action; patients were relocated to give the trauma activations space, surgeons poured out, and everyone donned on lead aprons. Teams and roles were designated, kits for procedures were opened, face shields were handed out. When the patients arrived, a frenzy of action happened. We all learn in medical school the steps of a trauma resuscitation: airway, breathing, circulation, disability, exposure. But to see it done rapid-sequence by a team of experienced practitioners is somewhat amazing. On one side of the room, a resident was rapidly calling out his exam, the attending was calling for X-ray, an anesthesiologist was placing an airway, a nurse was pushing meds, a pharmacist was preparing drugs called out, a medical student was doing a rectal exam (it's always a medical student). On the other side of the room, chest compressions were started for a patient in pulseless electrical activity, and a code leader was running advanced cardiac life support. Unfortunately, with the injuries sustained, the patients did not make it, but it was a really impressive effort. Trauma is not my thing (I'm an anesthesiologist, I like controlled situations), but there's something to be said about the adrenaline, dynamics, surgery, and medicine that goes into it.