A medical student’s first trauma

“Code fifty-two, emergency room.  Code fifty-two, emergency room,” blared over the loud speaker in the hospital.  Simultaneously a chorus of beepers went off, like crickets on a sticky summer day.

I glanced down at my pager that echoed the same message “CODE 52, EMERGENCY ROOM.”  The same message flashed across the screen three more times as I ran quickly down the main hallway.  Code 52 meant trauma.  I was about to partake in my first trauma ever.  Dr. Shyer suddenly appeared from a small tributary hallway leading into the main one that led to the ER.

“Come with me,” he said, and I stepped in line behind him as we continued swift down the hall.  Dr. Shyer waved his ID card up to the scanner; this was followed by a quick beep and mechanical whir as the automatic door lurched open.  I felt the tail of my white coat brush up against the barely half-opened doorway.

A small army had assembled near trauma bay one.  Slightly blurred through the sliding glass doors of the entrance I saw a flickering red and blue light quickly grow in size.  The sound of sirens broke me out of my trance, instead of the usual dopplering of the sound as it zoomed past, the sound grew from a distant whine to a persistent and ear-shattering level as the ambulance pulled into the drive.

EMTs clad in all black uniforms with yellow block lettering brought him in on a stretcher.  A coordinated heave transferred his limp, seemingly lifeless body onto the ER bed.  A flurry of activity commenced.  Two large bore IVs were stuck to continue adequate fluid resuscitation.

“Single motor vehicle accident.  Car was wrapped around a telephone pole,” I overheard a woman in all black say.

“We need a chest tube, now,” Dr. Shyer calmly stated, with the slightest thread of urgency stringing along behind his request.

“Someone get shears. I need shears now,” a trauma nurse barked at her colleague.  There were hands coming from all directions, working on multiple things all at once.  Suddenly a tentacle shot out and sheared through what remained of his clothing.

“You! Have you put in a Foley before?,” Dr. Shyer glanced in my direction.  Of course, I’d put in a Foley, it was a requisite job of the medical student on a surgery rotation.  But in a fast paced environment where it might actually matter, no absolutely I had not.

Before I had time to respond a nurse threw a sterile Foley kit at me.  It was like my body switched to a survival instinct driven place and I was on autopilot.  The countless times of gingerly placing the sterile glove pack on the table and practicing gloving without breaking sterile field paid off for me as I effortlessly gloved myself.

Break seal.  Sterilize with iodine. Lubricate piping.  Advance until a flash of urine.  Inflate balloon.

A stream of pale yellow slowly snaked its way through the piping.

Pete, the other student and I exchanged glances as I weaved out of the way and traded spots with him.  Just one beat was missed as I took over the rhythmic chest compressions, on a sardonic note, to the beat of Stayin’ Alive in my head as we had been instructed in CPR training.

The ER attending took a step back.

“Is there anything that we have not tried that anyone would like to try?” he glanced around the room and continued “I believe we have done everything we can.  Time of death 13:46.”

And suddenly the room was empty.  We donned our white coats that had unceremoniously been thrown over the nearest chair back as we had rushed into the room.  I slowly reaffixed the flat, pearlescent buttons on the front of my coat, redraped my stethoscope around my neck, clipped my pager to the waist of my sea foam blue scrubs and waived my ID card to let myself out.

Shama Patel is a pediatrics resident.

Image credit: Shutterstock.com

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