A resident ’s dream turns into cold reality

It’s every emergency resident’s dream to be part of a big procedure: The rush of a heart-pounding, adrenaline-filled moment of slamming in a chest tube, “criching” someone or being part of the big show — a thoracotomy. The holy grail. Cracking a chest, performing intracardiac massage, cross-clamping the aorta. A last-ditch effort to pull a patient away from the clutches of the grim reaper. A typical level-one center hums to life when a paramedic call comes in of a penetrating trauma to the box. Everyone and their mothers run down to the ED. There is, of course, the ED team, the trauma surgery team, pharmacists, techs, a battery of nurses and even an anesthesiologist or two may mozy on down. It’s the middle of a busy typical county weekend night. The usual: sick medical patients getting intubated, drunks acting a fool and confused people that haven’t realized that the ER is meant for emergencies and not for a cough and cold. Suddenly the call comes in — a 24-year-old with multiple gunshot wounds. Unstable on the field. ETA five minutes. My senior resident and I run over. He sets up the airway equipment. I open a thoracotomy tray on the left and head over to the right with a chest tube tray ready for action. The page goes out. The patient arrives just before the trauma team showing up. Paramedics are bagging and performing CPR. “The patient just lost pulses,” announces the paramedic slamming on her chest wall. Continue reading ... Your patients are ...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Emergency Medicine Residency Source Type: blogs