Sunday, November 11, 2007

Weekends Are Fun. Right? (2a)

More Saturday; I'm beginning to think this weekend isn't worth the telling. It's harder to write than it was to do. Well, I've started anyway...

While car crash fella was under the knife, our attention was diverted by car crash gal, and another trauma that BASICs seemed to have smuggled into Majors. I'm sure they didn't do it deliberately, but 'twas a while before I found them.

Car crash gal, was the passenger in the same wreck that gave us the fella on the operating theatre. One of my SHOs ran the rule over her. My eyeball of the patient had suggested she was a bit more stable that the guy, but still...

Sure enough, although her numbers were all in the right place, and stable, she had considerable bellyache, and was developing a bit of rigidity. There followed a slightly confusing conversation with my colleague on call for radiology. What I wanted was a CT head and abdo. It seems that we scan all or nothin' here, so was I sure that's what I wanted. My SHO had been a bit 'uncertain' about the physical findings on the phone. My big beef with radiology is this. They have fixed criteria for what they'll scan. Fair enough, they are the guardians of ionising radiation, which is not a toy. But, without seeing the patient, I don't see how you can say they aren't tender enough to warrant a scan. Or, because their numbers are normal, they don't need one...

So one has to be fairly definite about what the problem is; it's the least they deserve.

Reluctantly, she went through the scanner.

Which showed free air aplenty... (For those uncertain, this is not a good deal. It's not like free chocolate. You don't want anything free in your belly, really...)

Another for the surgical conveyor belt; it transpired she had a few holes in her small bowel, which is a not uncommon result of a deceleration injury. More evidence that people lie and cheat, even when they ain't trying. This wee lassie had significantly more serious injuries, but you'd never have known it to look at her...

That must be it, right?

No.

The trauma smuggled in turned out to have an unstable lumbar spine fracture, but thankfully no cord injury, and our night was completed by a six a.m blue call to an unstable MI. Chest pain, with fat ST elevation, uncontrolled hypertension, and profound hypoxia...

I'd like to say I was cool under pressure and successfully treated all of his problems, systematically, and thoroughly.

It didn't quite work out that way.

God Bless Cardiologists.

1 comment:

Holly said...

On this side of the pond, especially in TX and the Western States, we call what you had this past weekend, "Going Rodeo", Doc. I hope you have a few days to recover from all the hubub.