Hurray for the Red, White and Blue

So, I had to work in the E.D. this Fourth of July. Missed the local fireworks' show again. It seems as if I haven't seen a 4th of July show since I graduated from medical school. Like I said in an earlier post, the medical year starts on July 1, and it seems like I've always been on-call or working on this day.

Not that I can really call today work. In fact, I only saw 3 patients in the eight hours I was at the hospital. Why only 8 hours? Well, I got sent home early because there were so many providers (an attending, a fellow, 4 residents, and a physician's assistant) and about as many patients. Why only 3 patients? See above.

I actually thought it was going to be a crazy shift when I first arrived and was promptly directed to get dressed and head into the trauma room. We had a nine year old who fell through a glass door. He managed to cut through his axillary artery, a major blood vessel which feeds the arm located just underneath your armpit. His parents initially took him to another hospital which really only lead to a delay in treatment since they had no idea how to manage such a case.

Upon arrival to our E.D. he had bled so much and received so much fluid that his blood was like Kool-Aid when we were drawing labs. The surgery attending controlled the bleeding with his fingers, and the patient was rushed upstairs to the O.R. We later heard that he had been transferred to the Pediatric ICU with a pneumothorax (collapsed lung) thought to have occurred during the initial trauma. I'll probably find out how he did when I go back tomorrow.

That case took up about the first hour and a half of my time. When I came out of the trauma room, I didn't pick up another patient for another half an hour. I finished all the labs and work-up on the patient, and then sent them home. That's when I was able to pick up my next patient, almost 2 hours later.

So, how do you spend your time when you are sitting around waiting for patients? Why, of course, by talking about past patients and personal experiences.

One of the threads of discussion centered around the trauma case. The child had beensweeping a patio area when he stumbled and fell through the glass. We were amazed at how doing something as simple as chores could turn out to be so dangerous and then recounted many tales of events where we should have been dead but nothing happened.

mine was silver

I always think back to high school and the time I stuffed 9 members of my track team into a 4 door Mazda GLC. I was driving, two girls sat in the front bucket seat, 3 girls sat in the back seat with 2 other girls sitting across their laps, and another 2 girls jumped into the trunk. We drove from our high school to our brother school for a track meet - on the freeway, about 5 miles away. That was a tragedy waiting to happen, that surprisingly didn't.

The nurses jumped in with some of their best personal and patient stories. We ate, we laughed, we watched the clock. Finally, I was given the tap on the shoulder. Go home. As a medical student, I was told to never argue when your resident told you to leave. Just say, "Yes, thank you," grab your things and walk out the door. Which is exactly what I did.

Another day of pedi fun tomorrow as we see what damage was done by the holiday. And the fact that most pediatric offices will have been closed over the long weekend, and some things that have waited this long just can't wait a minute longer...