Shouzer

It occurred to me tonight after I got home from work, showered, and changed that I hadn’t posted about any of my experiences in the ER recently, and today was a great day for me (though not for the patients), so I figured it was time for another update.

Started off fairly slow, but a nice steady pace, nothing too major or crazy, but that would all change, of course.

It changed around 11 a.m. when our transfer from Herrin Hospital arrived. It was a 68 y/o female with necrotizing fasciitis. This is a severe systemic bacterial infection. It starts usually when the patient gets a small cut or scratch. Her infection was so severe it involved all layers of the skin, her subcutaneous tissue, muscle sheath, and muscle tissues themselves.

From the report we got from Herrin’s ER, when she arrived, her arm was red, blistered, and swollen to just below her elbow. When she arrived here, it had spread up to her shoulder and there was crepitus (air in her tissue, it felt like bubble rap packing under her skin) all in her chest.

Since it was spreading so quickly, we rushed her to the OR where they had to amputate the arm. Her chest film after the amputation revealed that it had spread further across her chest and was now near her left arm as well. Her prognosis is not good at all.

My second major story deals with a man who fell 65 feet off a scaffolding downtown. When he fell, he hit a beam or piece of sheet metal and it amputated his left arm. It wasn’t completely severed, it was still attached by a little bit of muscle and tissue. He was in bad shape from the fall, obviously and was in severe shock from the blood loss. He was also rushed to the OR.

The cool thing I got to do on him was assist the Trauma Chief tie off his bleeding brachial artery and his cephalic and basilic veins. That was pretty freakin’ awesome, though probably only Al would get as big a kick out of it as me.

After assisting, I was on extremity duty for a bit. I had to make sure the arm remained covered, clean, and cold. It’s sad, but it served as a great anatomy refresher.

That was pretty much all of the exciting stuff for today. Everything else was pretty much run-of-the-mill normal stuff.

Hope you guys are enjoying your weekend!