Trauma OR and Burns

This past week I spent time in the trauma OR room and Friday was spent in the hot Burn OR for two cases. We are adding up our cases, tallying our statistics on Medatrax, so that we can have a full experience as SRNA's. The life of a student Nurse Anesthetist is too full. This week however, I had time for reflection.

The great thing and the bad thing about statistics is that they are so impersonal. It's like hearing in the news that there were fewer traffic fatalities this holiday season, only 8 highway deaths over Christmas week down from 12 last year. Interesting unless you are related to one of the unfortunate tragedies. The trauma OR room is like that too except you get to see the results up close, too close really.

There was a case this last week that had me thinking for days; actually I have not stopped thinking about it really. Just another small statistic probably not even making any news but terrible never the less. An out of town woman was hit by a car and made it to the emergency room after being thrown 10 feet or so as the report reads. She was rushed to the OR for neuro-surgery after her level of consciousness decreased and her CT scan revealed active intracranial bleeding. I am use to taking care of these unfortunate victims in the intensive care units but this was my first experience with a large trauma in the OR.

It was pretty much a rush with 3 surgeons, an anesthesiologist the chief CRNA and myself helping out. As a student I basically took orders, started an arterial line and functioned at the head of the bed with the Chief CRNA behind me. We were all very busy. This person had multiple injuries, pneumothorax requiring a chest tube, fractures limbs and the head injury which was severe. What I keep thinking about now is this poor women and her family. At the time we were busy with her anesthetic and there was not a moment for reflection.

The surgery went well actually and the pressure in her brain was relieved. After the craniotomy her blood pressures settled down and we were able to keep her stable with titratable medications. As far as the general anesthetic was concerned, this also went fairly smoothly. She will need additional surgery for her other injuries but they can wait till the morning.

I went to see her in the ICU the next day. She was still intubated, sedated and seemed to be doing alright. She had woken up and moved all of her extremities but the nurses told me that they were not able to assess her neurological function yet. Seems reasonable and hopeful. Her family was coming from out of town. That all seemed so sad for me that this all happened. The one good thing is that she would have died had it not been for the quick abiltiy to detect her bleed and releave it. Maybe this strikes home to closely. Perhaps I will comment on that someday.