Guy in our unit in respiratory distress - drowning in his own secretions basically. Two hours trying to manage him. Eventually admitted him to the ICU.
Lady in our unit desatting to the 80's. She perks up with nebs, but is supposed to go to a nursing facility today. I have a sad feeling that she will be back to us with pneumonia and imminent death soon. She has some gnarly rib fractures and is in her 70's or 80's. That has over a 50% mortality rate. No joke.
Trauma - Fall 71yo, head bleed. Non-English speaking. REALLY hard to get a hx. Finally got an interpreter.
Trauma - Fall 71yo, head bleed. (yes again). She doesn't look 71. She is SUPER fidgety and twitchy. Hers was an alcohol related fall. She hit her head and knocked herself out. Here is where I was a little proud of my sleuthing skills. She says that she has been drinking for years, but that she only drinks 2-3 glasses of wine a night. So I ask, "Do you empty the bottle with those three glasses" to which she says, "Well there's a little left". SWEET, score for me! THEN, I later find out that her "bottle" is one of the liter and a half double wine bottles. Damn it! Now I have another question to add to the bank though! She required a buttload of sedation to stop moving in the CT scanner.
Trauma - fall 91yo, sweet as all get out. Possible cord involvement, but lower extremity weakness is resolving. Impressive cervical CT. Crazy looking at it that this lady has the use of all 4 limbs (old injury we are suspecting)
Trauma - 31yo - got drunk and crashed her car. Chunks of her hands taken away. Glass all in her wounds on xray. Her hands look like Freddy Kruger. She lost most of the skin and was down to ligaments and tendons. It was insane looking.
Called to OR for emergency surgery. They asked for the PA student to scrub in. I was like, "you're sure they asked for me?"
A girl about my age that has been on ECMO, had her spleen spontaneously rupture. They need another pair of hands in there to help. So I scrub in and it is insane. You are anti coagulated on ECMO, so she is bleeding like nobody's business. They are throwing deep ties on her splenic artery and other bleeders. They seem to get that under control, but there are other things like the liver that is spontaneously bleeding. They give me the bovie and ask, "do you know how to use this?" I say yes, and they say, "stop the bleeding." They are trying to work on her femoral artery to get a new line for ECMO in there. Meanwhile the bleeding is not stopping. The vessel gets a stitch, but she is bleeding from everywhere else. They get the other line, but her vessels are so clamped down that they can't really perfuse her. We did everything that we could but there just wasn't anything more that could be done to help her. So she died. It is sad. Sudden for her family, although she has been in critical condition. It doesn't even seem real.
Trauma 0530: Guy that fell at 11pm. Got drunk, fell down, was locked out of his house. Finally got in, looked at his head, realized that he needed to come to the hospital. Arrives to us at 0530 as a trauma. He is still wasted (1$ duck farts for any score in the game I guess) He comes to us with this. Impressive. I have his permission to take and use these pictures
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