Yesterday was day (or night actually) #2 - it was slow and then it all hit the fan for awhile. 1MVC w/ multiple rib fx, clavic le fx, intraparietal bleed and 6.5cm liver lac - fairly impressive - I did the admit orders (and apparently I am ultra conservative fro pain meds). A drunken older lady fell down went boom, gave herself a great black eye and another head bleed - I admitted her too. There was a level 2 brought in, so fascinating that I can't remember what he had. Then there was the guy (former PO) that was shot in the head 5 yrs ago, severed his carotid, he suffered a major right hemisphere infarct - he fell out of his wheelchair and broke some ribs. And this morning young guy, MVC, open femur fx, multiple rib fractures, lung contusion and effusion, liver lac and fluid in his abdomen from unknown source. The resident was itching to do exploratory last night but the attending put cortisone cream on that. Somewhere in the middle of all this excitement 2 pediatric cases slipped in stealth mode onto the children's ED side. They had driven themselves to the ER after being shot with a 9mm - it wasn't until the pediatric ER doc asked for a consult that we even knew they were there. There were two of them and so the PA asked if I could do one - ABSOLUTELY! From H&P, imaging, to d/c he was all mine ( I had a little help with the CTA of the Upper extremity where the bullet went thru and thru). It was very gratifying. I think this is why I am not super sure about one of the traumas - I was going back and forth from peds ER to trauma bay reporting and trying to get all the appropriate paperwork done. I would be surprised if we saw these two again - maybe DOA since this was not their first or second time being shot - lucky no serious injuries this time around.
May people continue to do stupid things, have accidents and be in the wrong place at the wrong time - you are all helping me with my education - thank you!
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