Starfish of Death

Not an actual medical term you would find in Harrison's (trust me I looked) but cool none the less. Pt synopsis: single motorcycle crash - wearing a skull helmet - found down w/ agonal respirations was flighted in oh and body habitus = 120+kg. End result: skull cap helmet NOT effective, massive head bleeds, so much in fact in several vies of the CT there is no differentiation between the grey and white matter and you can't see the ventricles in the brain - bad sign and in several CT pictures the starfish (of death was pointed out). Other than the massive head injury nothing else going on. Lifeflight needled her 4Xs - and missed the pleural cavity with all four due to body habitus. She didn't have a pneumo though until she was getting PEEPed. Then two attempts at a chest tube. Literally this pt was was a small framed gal with a fat suit on - where you would think the 6th intercostal space was based on her size was in fact the liver/diaphragm - which I felt when rummaging my finger in the hole trying to feel the lung.
I also got to staple her head shut which was interesting trying to maintain C-spine and staple her occipital lobe nadn I watched a bolg be drilled into her head which measures intracranial pressure using a hand drill you can buy at Lowe's or Home Depot.
We also had a pedi trauma, which come to find out was a clark county original - not Shawn's but kind of fun to share patients. Speaking of Shawn. He worked 2a-2p yesterday and his usual 7:30a-p 12 shift today and tomorrow. I basically got home in time to say good morning, I love you and have a good day. This rotation will suck for family time for sure and I will be feeling these long hours for a while even after I'm done. I'm also still trying to save my brain - one antibiotic at a time - now I've got super high doses of septra too oh joy!