Agraphia Medical Tragicomedy

1Aug/07Off

1*1*5*3

In response to this great post by Fiznat over at Baby Medic, I figured I'd weigh in on the trauma side of things. A few weeks ago we got a case similar to what he describes - man found down in a concert - so I'll just start from the beginning.

Trauma pager goes off, 1*1*5*3. This is a level 1 trauma, 1 person being brought in, 5 minutes out, trauma bay 3. Anybody carrying a trauma pager sprints (or at least, run-walks) down to the trauma bay. I count 26 people already there when I arrive.

The room goes completely silent as the stretcher rolls in, so everyone can hear the rapidfire EMT report: This is a 27 year old male, fell while crowdsurfing at a concert. Friends say he was down for about 2 minutes until we got there. Unconscious when we found him, put a c-collar on, woke up 3 minutes later. Got a big-bore IV in for ya, doc, gave 'im a liter of fluids on the ride over. He's been really out of it since he woke up.

The first 10 minutes are a madhouse. Different teams are tasked to different things - one assesses the airway, one draws blood. If it's bad enough, one takes over for the paramedic doing CPR. One performs the physical exam, one cuts off clothes as quickly as possible - clothes can hide an awful lot of assorted cuts and bruises.

Physical exam reveals no life-threatening damage, but it becomes quickly apparent that Mustang, HA† cannot feel or move anything from the waist down. Physical exam completed, X-ray comes over like a smoothly oiled machine and quickly shoots films from his head down through his abdomen. Images are immediately put up on the plasma screens behind the bed. He's got a massive fracture to the thoracic vertebral column.

And then everyone leaves. I'm standing there with an ED tech and my intern. Because acute danger to Mustang's life has been ruled out, the extended team is no longer necessary. I tell my intern I'll stay with the patient while he's wheeled off to CT scan - someone from the team needs to stick with him - so he leaves to attend to more pressing matters. Now it's just me and Mustang.

Shit, man. I can't feel my fucking body. I can't feel my fucking dick! Am I gonna be alright?

He's crying. I've got no response. I mumble something about waiting to see what the CT scan shows. Hiding behind my false pretext, I wheel him off to the radiology department. 3 hours later a real doctor tells him he'll never walk again.

Next year, please remind me to choose a specialty that isn't depressing as all hell.

† All trauma patients are assigned a trauma name. This accomplishes two things: anonymity, and a name in the case that the patient has no ID and is unconscious. Trauma "last" names are reused - Mustang, HA is the 183'rd person to share that august surname.

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