(no subject)
Anne Quinn
English 113
Professor Newton
October 24, 2006
“It’s like candy but with blood, which makes it so much better!”
A big x-ray machine and the hustle of the x-ray technician may fool some people into believing that the extensive, flawless room used for x-rays is just a part of the radiology department in the emergency room at Palomar Medical Center. If you take a closer look, you would realize that the room is so much more. Cheerfully, a nurse preps the room for the day; the beginning of her extensive twelve hour shift awaits her. She has no idea what to expect, it is an emergency room, after all. The ethyl alcohol she uses to sanitize the equipment gives off a stinging odor that would make any child cringe at the thought of needles and a doctor’s office. She fills a silver box with a refrigerator-like door with blankets that will soon reach that one hundred twenty degree mark for that cold patient’s comfort. There’s a motionless gurney in the corner with clean white linens spread over the black leather sitting next to a cart that contains numerous medications. If misused, these medications could easily take the life of someone. These same medications when used correctly could potentially save someone who is seconds away from death’s dark, wretched grasp. In the opposite corner, there is the common blue “crash cart” with drawers labeled for each and every emergency situation imaginable to the mind. This goes unnoticed most of the time because it is only one of many “crash carts” in the emergency department. At a first glance these big items seem normal sitting in the x-ray room, but it isn’t until that overhead page is heard and the trauma code is put into effect that these objects get their chance to come to life and possibly save someone.
The hospital operator’s voice is calm and collected as she firmly speaks through the microphone, “Full trauma team please report to the emergency department. Full trauma team please report to the emergency department.” The page is heard throughout the entire hospital and both patios. The trauma doctor and nurse, phlebotomist, x-ray technician, specialized nurses from the critical care unit, the house supervisor, and I, the ER technician, all make our way to the room hidden in the corner. The Emergency Medical Services usually give a good five to ten minute notice when a trauma patient is being transported to the hospital, giving us enough time to prepare. A very common misconception about the trauma scene is the organization. Most TV shows and movies portray a trauma to be disorganized where no one really knows what is going on. The only time this happens is when the trauma is a walk-in trauma and the emergency staff has no idea they are on their way, and even in that case it only takes a moment for everyone to catch their breath and get into routine. In every other situation, the doctors and nurses follow the standard procedures and the trauma tends to flow smoothly.
The constant beeping of the radio in the corner of the radio room tells the nurses that the helicopter or ambulance is close. Over the radio Kimberly Hunt, the trauma team lead nurse at Palomar Medical Center asks, “What do we have?” She eagerly awaits the report for what she is about to work on. “Twenty-eight year old male, arriving by Mercy Air. He was involved in a motorcycle accident wearing a helmet, external injuries to the right arm, lower back pain, and right shoulder pain.” Kim nods with a smile, sending her team to the trauma room to suit up. We all hurry to the room and put on our heavy lead aprons that are a shiny retro vinyl, red in color, and some of them even detailed with silver glitter. “Let’s do this!” she exclaims enthusiastically.
The shaking of the hospital walls and blaring propeller inform us that the helicopter has made its sizeable landing upon the helicopter pad. Grabbing the thick metal gurney kept out of the way of ambulance runs is used to greet the flight team. I take the cold uncomfortable bed outside to meet the team. Making my way up to the helicopter pad, I must go around the front of the aircraft to avoid any contact with the hungry propeller slicing swiftly through the air. This is my chance to see how severe our trauma actually is. The wind from the dying propeller still has the power to move the dust from the ground and blow my hair into my face, making it an obstacle in loading the patient onto the gurney. Once the patient is successfully locked and loaded, he is taken hastily through the green automatic doors at the mouth of the ambulance bay to the central emergency room, around the corner to the right and into the immaculate room where the rest of the team is ready and waiting eagerly. As the patient is taken off of the metal gurney and placed on the table, his screams are heard throughout the third floor. “It’s going to be okay, pumpkin,” Kim jokes as she sticks a needle into a tiny jar, preparing his medication. If the patient is conscious, Kim likes to keep the mood light to ease some of the patient’s fears. As she is preparing his meds, a paramedic intern jumps in and places and intravenous line into his left arm, because you would never want to put an IV into the arm on the injured side, if it’s at all avoidable. Here I am sitting at my little table, which is more like an oversized clipboard, in the corner next to the medications. Every little thing the nurses or doctors tell me, from the medications administered to tests that need to be ordered, I have to document in the patient’s chart. The mass chaos of words flooding their way to my ears can get confusing; thankfully the nurses are good and go over everything with me once the patient is done being worked on.
When the patient is off of the backboard and placed onto the trauma table, the once sanitized table is taken over with the slimy, clotting blood protruding from the man’s wounds. The smell of the blood diffuses from the patient’s body into the air, creating a thick aura of iron and plasma. The wet, bloody smell becomes a flavor, seeping from the nostrils into the taste buds of any bystander, making sure it’s an aroma they will not soon forget. The patient’s moans and groans are minimal compared to the high pitched shrieks once heard before the pain medication is administered through the IV.
“X-RAAAY!!!” Once x-ray is yelled, the mixture of colors from the variety of scrub tops surrounding the man disperses to avoid any contact with the gamma rays emitted from the x-ray machine. It is very interesting to see how so many people can be around one person on a table doing multiple tasks on one body, then at the drop of a hat just stop for the three seconds it takes to snap a picture of someone’s insides, and go back to how it was before the picture was taken. Once the x-rays are completed and the labs for the patient have been ordered by the trauma physician, the patient is loaded onto the spare gurney to get a Computed Axial Tomography scan, or as some call it, a CAT scan.
We must take the patient to the portable CAT scan, or as we call it, the “scan-in-the-can,” since the hospital radiology department is being remodeled. Wheeling the patient through the doors to the clear, beautiful daylight, we arrive upon the elevated trailer where the patient will undergo a scan of his brain. Pushing the gurney onto the loading dock poses a difficult task, since the loading dock is just big enough for the gurney and one person. I choose to take the stairs to the inside. Once the patient is inside, the demanding work is not yet complete. We must squeeze the gurney, nurse, ultrasound tech, and myself into the small (poor excuse for a room) trailer. Once the patient is on the machine’s bed, we all must leave the CAT scan room and go into the near by ultrasound office to avoid those gamma rays again.
Once the patient is done with his CAT scan, he is placed into one of the regular ER beds, and the room is cleaned up for the next patient.
Not all patients are fortunate enough to make it to the CAT scanning process. Kim explains that one of the hardest parts of her job is losing patients, as in the young man who had a seizure on a twenty-five foot scaffold, causing him to plummet twenty-five feet and land directly on his face. It wasn’t until his x-rays were taken that it was discovered that he had broken his C-1, the first vertebrae of the neck, that he was pronounced dead. Doctors say it is nearly impossible to break the C-1 vertebrae, but this young man did, and when he did, he also severed his spinal cord, internally decapitating himself. “When something goes wrong during a trauma code, or even just the situation that is brought in, things can become very confusing,” explains Kim, referring to a trauma from her past in which an eight month pregnant woman was sitting at an RTA bus stop, when out of no where an SUV loses control and overturns on top of her. Thankfully the EMS arrived and transported her to the hospital, where her baby was delivered by cesarean section and her extensive injuries were taken care of to the best of the trauma team. Thanks to the trauma team and the EMS, the mother, with her newborn baby in her arms, walked out of the hospital after weeks of recovery.
Many people have an impression of the trauma room as a room where only scary bad things happen. “Helping people who have been through physically traumatic events is what I live for,” expresses Kim, “to some it’s just a high speed room in a hospital. To me, it’s my home away from home.”