Friday started out like any other day. At 6am I'm checking in on my assigned patient followed by signout at 6:30 and case studies at 7:30. We were just finishing up our case studies when the trauma pagers went off. It said "Level 1 trauma. Response STAT. Multiple adult and pediatric traumas." This was the first time I had seen a page like this. The most I've ever seen at once was 2. As usual we all stopped everything and ran downstairs to the ER. We got there and learned that there was a car accident and five teenagers were traumatically injured. All of these kids were in the same car and were on there way to school when they collided head on with another driver. Four of the five victims were unconscious and had to be extricated from the car. They were being flown in. A trauma of this nature required that every ATLS trained person in the entire hospital respond. I would guesstimate that around 50 people were involved directly in these traumas. It sounds like complete chaos but it went amazingly smooth. I was super impressed with how well orchestrated everything was. Every room had someone in charge and also had someone responsible for communicating with the other rooms about who's patient was the sickest and needed CT scanned first or the first available OR, or needed the massive transfusion protocol activated. I apparently drew the short straw because I ended up in the room with the sickest kid. He had major head, chest, abdominal, and orthopedic trauma. I was in the middle of this trauma when a nurse yelled that I was being paged to the OR by one of my attendings. I stopped everything I was doing and passed off my responsibilities to someone else and bolted upstairs to the OR.
I walked into the OR and the attending had already opened up and told me he needed another set of hands and to go scrub in. At this point I still had no idea what was going on because as far as I new this doctor was running a trauma two doors down from the one I just left. I got all scrubbed and joined the doctors at the table. Here the patient has was operating on was the driver of the car in the major accident. He required IMMEDIATE surgery to save his life. The boy had demolished his spleen among other intrabdominal structures and was actively bleeding out. I will spare you all the gory details of the procedure but let's just say it took around 3 1/2 hours to do what needed to be done. I'm happy to report that we were able to stop the bleeding and do adequate damage control to save his life. I haven't heard anything since I left the hospital Friday so I'm not sure of his current status.
This was the first time I had ever been paged to the OR to assist in a life saving operation so I was feeling pretty good about myself. However like most good trauma related feelings this was short lived. Once the urgency was over and things had stabilized the reality of what just happened set in. This was a 16 year old kid, he has a sibling in the OR a few doors down undergoing a similar operation. This family was just turned completely upside down in a short second. In fact four families were turned upside down. When I go into the hospital tomorrow I'm going to have to face these families. That is perhaps the hardest part, seeing the look of despair and sadness on the parents faces. As a student I usually do not have to talk to the family but I still have to be in the room when the doctor does. Hopefully tomorrow the questions that the families ask will have positive answers. I'm going to keep the attitude that they are kids and they bounce back quickly! Only three more days of trauma, then it's off to take care of kiddos who are not teetering on life's edge.
*the picture at the top is a grade 5 splenic laceration, one of the injuries we were repairing
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