The flight team brings the patient into the trauma room. The patient is lifted on three and placed on the trauma bed. And the orchestra begins. The flight crew gives a report that includes mechanism of injury, what was done for the patient by the ground crew, what they did for the patient, and any obvious injuries they noted. I verify my tube position, place the patient on a ventilator (life support), and adjust the settings. One of the ER doctors begins the primary assessment (airway, circulation, and neurological responses). One of the trauma surgeons then begins the secondary assessment (injuries and abnormalities to the body). A nurse checks a manual blood pressure. Bad news, it’s low. A tech places the patient on the monitors. Another nurse checks the IV lines and draws blood for lab work. A tech runs the blood to the lab. Another doctor exams the patient with an ultra sound machine and finds free fluid around the liver. More bad news. “O” negative blood magically appears and two nurses verify the blood products and start transfusing. The radiology techs have taken x-rays of the chest and pelvis. Two more doctors evaluate the x-rays (we have instant digital x-rays on a computer screen). Another doctor, a radiologist examines the x-rays in his reading room. The attending trauma surgeon says, “Initiate the mass transfusion protocol. Notify OR, she’s going to surgery.” (We’re at five minutes)
Another chain of events begins. The blood bank is notified and they start processing blood products. The OR is notified and they start setting up for the patient. I call the anesthesiologist and he comes down to assess the patient and start his paper work for giving blood and medication, while his assistant sets up his equipment in the OR. I grab the transport monitor and ventilator. The doctors start subclavian and arterial lines. More tubes and lines are placed in the patient. I have a moment, so I remove the metal barretts from her waist length hair and braid it. (It’s a safety and hygiene thing and it’s also a nice thing to do.) We put on masks and hair covers. The patient is placed on the transport equipment. We check to make sure everything is clear and ready for transport. There is a nurse in the corner that has documented everything everybody has done.(We’re at about twelve minutes)
The entourage migrates to the OR suite one floor up. We move the patient onto the OR bed and monitors. The anesthesiologist takes over ventilation (life support) from me. Report is given to the OR staff and the ER nurse and I leave. As we remove hair covers and masks the nurse asks me, “How did we do?” I looked at the time, “Eighteen minutes.” The nurse says, “Nice”, and smiles. *Fist bump* A life saved in 500 words or less. (about 480)
The purpose of this post was to emphasize the importance of clear and concise communication. That will be 500 words.