Chatting with my partner and a supervisor in the hallway of one of our hospitals after we brought in a guy that was all shot up. Well, actually he only had two wounds, one in his belly and one in his arm. Surprisingly, the one in his arm is the one that almost killed him before anyone got on scene. Seems the bullet nicked his Brachial Artery and a good deal of his blood left it’s proper place and ended up in his clothes, on his clothes, one the street, and finally on our stretcher.
The other holes were in his abdomen and although they weren’t the immediately life threatening ones, the injuries in between the two holes are going to keep the surgeons busy for a few hours. I got a distinct whiff of bowel, which is never good.
Still and all, he was moving a bit when we arrived, which is always a hopeful sign. We decided he needed to be intubated since he was essentially unconscious. My partner opened his airway and ventilated the patient, which actually woke him up a bit, but he still needed the tube and was going to get it without benefit of medications.
While my partner was doing that, I was cutting off clothes trying to find the hole so I could stop the bleeding. Did that, but it was a mess. We were already on our way to the hospital when I pulled out the intraosseous gun and got ready to drill. Only we pulled into the hospital at this point and we figured it was better to get him into a resuscitation room and let the surgeons do their thing.
Which they did, including putting in a intraosseous needle and giving the guy blood and saline. Both of which brought his blood pressure up and started to wake him up. They fixed that with Ativan and a paralytic drug, but still the signs were encouraging.
Which brings us to the conversation in the hallway.
TOTW: “His pressure is up to 144/57, his pulse is 130, and he was trying to sit up.”
Supervisor: “That’s pretty good.”
Partner: “He’s doing OK.”
Pregnant pause as we look at each other, then look back at the activity in the trauma room. The patient is intubated, his clothes have been cut off, he has a Foley Catheter in his penis, he has multiple IVs, he is getting his third unit of blood, an intern is placing a chest tube, he’s sedated and chemically paralyzed, and they are prepping him to go to the OR. If he survives surgery, he’ll have a colostomy bag at least for a while and might lose his left arm.
Supervisor: “Well…”
TOTW: “Well…”
Partner: “Well…”
“Doing OK” is a relative term in medicine.
He’s doing okay… Meh… well, if ALIVE is counted as doing okay… Sounds like it’s a good thing it was a short transport!!!
It’s kind of a Disneyland thing.
Out “there” is a rough world and a lot of people fall down. We pick them up and do what we can. If we manage to get them in to the gates of the Magic Kingdom alive, then we walk away with visions of our former patients prancing around from ride to joyous ride, stuffing their faces with cotton candy and laughing in glee.
Is it fair to say that the majority of us in the majority of situations do NOT go back seeking to learn the REAL outcomes?
Why should we; we’re Hope Fiends!
Russ – I’ve always thought of it as Disneyland, but not in the way you described it. That’s pretty good. My view has always been more of a “Dark Tower” wasteland kind of scenario.