Our Trauma rotation starts with a 13 hours weekend shift. As a clinical group we must decide amongst ourselves who’s going to cover which shift starting from 6PM on the Friday to 6PM on the Sunday. I was one of the four brave souls who had decided on covering the Saturday night. This would have been my very first exposure to trauma, ever! and my first overnight shift so I was nervous but really excited too. I didn’t really know how to prepare for the call, I figured that if I slept during the day, staying up whole night would be easier but after multiple failed attempts at napping throughout the day, I decided I’d just watch Code Black for mental preparation. Call was scheduled for 6pm so around 4pm I started getting ready for it. There’s only really 3 things you need for a call;
So I had packed enough food to last me a week. Imagine being hungry at 3 am and not being able to eat because you don’t have food. No one deserves this plus I’m really not myself when I’m hungry.
18:00 – call started with the handover ward round. We joined a team of about 4 or 5 doctors. We received a short briefing on how to assess trauma patients, what was expected of us, resuscitations protocol, general casualty rules etc. After the briefing we were all given a patient to clerk which meant presenting complaints, ABC assessment, diagnosis and management plan. We’d discuss this with the senior doctors on call and they’d either agree or correct our management plan. We were expected to carry out the more basic management plans like suturing, setting up IV access, ABG, blood collections and administration of medication.
21:00 – the first resuscitation case was brought in by EMS, a 30-something years old male victim of a bar assault with multiple lacerations to the face and torso, which meant we had to stop with our minor cases to help stabilize the patient. This was happening so fast, the doctor in charge quickly assigned tasks to the resus team members, I was asked to put up a large bore IV line in the right arm, put in a urinary catheter and do a blood gas. I had successfully inserted my fair share of IV lines, even though I was out of practice I had rotated through Urology earlier this year so I had no excuse for struggling with the catheter, a blood gas however, I had only ever seen it being done once but I was ready to try my luck plus I had a team of colleagues that were ready to offer some guidance if needed. The most stressful part was finding all the equipments needed, the running around asking the nursing staff where you get find the right size catheter, warm fluids, the right syringe – I swear I almost past out from the stress. Even though there was a lot of blood, I was surprised and impressed at how calm I remained. I had obviously matured up a lot since my previous exposure in the emergency department. (You can read about it here)
01:00 – I’m starting to feel quite tired and hungry by now; I had assisted in a few resuscitation and stabilization, seen an non-ending queue of minor injuries and a few more serious cases too. There was a lot of stabbing, gun shots, assaults, car accidents and a lot of drunk people over the last 4 hours. I’m not myself when I’m hungry so I had to stop all this doctoring stuff and eat for the first time since the shift started. It felt great to get off my feet, reply to a few texts, record a Snapchat or two and just eat for a good 20 minutes or so. The only thing that was able to get me excited about going back was suturing. Because there was a few students on call, I hadn’t gotten a chance to stitch up someone so when the doctor said there were a few cases that needed stitches, I was more than happy to cut my lunch/supper/breakfast, uhm let’s just call it my break time short. My first case was a 25 year old male who had been stabbed in the back by his best friend literally (this statement makes me laugh, I honestly don’t know why though). Again finding the equipment and space to do it took most of my time but finally I was in my happy corner suturing. I saw another 3 or 4 suturing cases after that, before I was called to assist in a few series of resuscitations. One was so severe that they rushed him to theatre a few minutes after arriving which meant I had to run to the blood bank to get his blood bags and then run to theatre after that.
04:00 – At this point I was getting hungry again and I had been tired. I was starting to get grumpy, like I had mentioned earlier on in case you missed it, I’m not myself when I’m hungry. It didn’t help that most patients were just not cooperating so I knew I was just about ready to explode if I had to deal with yet another drunk patient so I took a walk along with some food too. I was gone for maybe 30 minutes, ended up dozing off for 10 minutes on my laps, my eyes had just gotten too heavy. Getting back into the hang of things once I had returned to casualty proved rather difficult but in no time I was running around again and seeing patients. There was a burns patient, a man with pneumothorax after getting stabbed in the chest by his girlfriend (I wonder what he did), another car accident (with a patient who didn’t want us to tell her husband because she told him she was at her mother’s and not out partying) and a femoral fracture (with a very odd history that didn’t match his injuries).
Around 5AM I sneaked out for 10 minutes to go see the sunrise and just have a moment to take in everything I had seen throughout the night. The realization of just how violent this nation was. Once I had returned to casualty everyone seemed out of it, we were all ready for this shift to be over. Around 7:30 am, it had quieted down a bit and the handover ward round was finally happening.
14 hours later I was done! by the time I got home, I wanted to eat, shower and sleep but my brain couldn’t prioritize what should had be happening first, so I sat for 20 minutes just staring at the wall. I zoned out a few times without actually passing out. I finally decided to just sleep but my body refuses to cooperate (don’t you just hate it when that happens). I ended up tossing and turning till about 11AM before I dozed off for the deepest 2 hour nap.