Digital Camera

My week turns on the first two hours of every Thursday morning. Since I am coming off three twelves in the city with my Wednesday evening shift not getting me home until ten at night, I need a quiet Thursday morning. I like to get to work at six, check my gear, then get in bed and sleep for two hours. If I can do that, I'm good to go, but if I get a call -- like this morning again -- shortly after I've walked in the door, I will drag the rest of the day, and on into Friday and then Saturday. Its just how it always seems to go.

At least my precepting student is here today, so its good for him to get a call, and I don't have to do too much, but sit back and watch.

It is steady today -- four calls.

An old man from the nursing home with chest pain, a woman at the doctor's office with chest pain, another woman from another doctor's office with dark stools, and then a good motor vehicle crash.

An old man probably falls asleep as he drives, drifts off the road and smashed into an old fashioned stone wall. Air bags go off, he comes to at some point finding himself in the passenger seat, bleeding from the mouth with a pain in his side. My preceptee did a fine job extricating the man, and then while he and my partner wheeled him to the ambulance, I pulled out my little digital camera and snapped off a bunch of photos to show them in the trauma room. On the way, my preceptee held off doing an IV until he had done everything else, full survey, vitals, oxygen, monitor, history taking, then and only then did he pop in the line. I try to teach my preceptees that in trauma what matters is getting the patient to the hospital. I had one preceptee once who despite all my lecturing in advance, the first big trauma we had, she grabbed a 14 guage needle and stuck the patient. She had no vitals, no assesment, much less a bag spiked or lock drawn up. She sat there looking at me, wondering what she should do now that she had an big catheter in the man's arm and nothing to do with it.

In the trauma room, after my preceptee gave his report, I showed the docs the photos. They were impressed. It made them take the patient who was alert and stable more seriously.