First Trauma Experiences

[corabrickdog]

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Is anyone willing to share their first trauma experiences I know it's kinda of a touchy topic for some people but I just want to get some idea of how people react to traumas and what happens. (I have no idea if this is the right forum to but this question so feel free to move it to the right place)

Thank You,
David

 

[JacobMcCandles]

The first few traumas I saw as a student the rectal exam seemed to be worse than any of the injuries they had.

 

[deleted109597]

Not sure what you're asking.

Trauma isn't a touchy subject.

You see people, some are hurt, some aren't. Some go home. Some die.

Some people are squeamish at first. Some aren't. Most get used to it. Some never do, and probably shouldn't deal with a field that involves any sort of gore.

 

[corabrickdog]

Not sure what you're asking.

Trauma isn't a touchy subject.

You see people, some are hurt, some aren't. Some go home. Some die.

Some people are squeamish at first. Some aren't. Most get used to it. Some never do, and probably shouldn't deal with a field that involves any sort of gore.

Thank you for saying this. I was just saying that it might be a touchy subject if there pt's died. But thank you for telling me this. And ya i know my question doesn't make any sense let me rephrase the question. What were your emotions or how did you feel about your first truma. And how did it go?

 

[engineeredout]

My trauma experiences as a student in the back of the room were pretty unemotional honestly. Its a neat thing to see a well run trauma team snap into action and go through the very algorithmic approach to trauma. I can't even remember the first one I saw specifically. The blood/guts never really bothered me, and I don't think I could ever be squeamish after doing a burn rotation. Not sure if I'm answering your question or what you really want.

 

[deleted109597]

What were your emotions or how did you feel about your first truma. And how did it go?

From med school? Can't remember it.
Pre-med? A guy ate a shotgun slug, was brought to my ED since he had lost pulses long before, basically so he could be pronounced. Had seen lots of failed CPR prior to this, but never a "trauma" as we weren't a trauma center.
Residency? Spleen lac taken to OR for emergent splenectomy. Did well.

Don't really remember the emotions.

 

[corabrickdog]

Thank you all for the story's and feed back.

 

[han14tra]

1st trauma I saw in medical school: Fight at 3am. Guy #1 broke into a house and killed Guy #2 in front of his children and wife. Killed him using a crowbar. Guy #2 managed to grab a butcher knife and fight back a little bit. Thus, we were treating Guy #1 (aka the murderer) for forearm lacs.

Emotion: Anger that this guy was alive. Later, my emotions were fear because I had to round on this guy every morning while he was in the hospital. I was so afraid to get close to him even with 2 armed cops in the room. I was also still angry because this guy kept asking me for extra blankets, special diets, etc. I wanted to say, "Kiss my red rosy behind" but I figured I better not. I was happy and relieved when they finally discharged him to prison.

 

[corabrickdog]

1st trauma I saw in medical school: Fight at 3am. Guy #1 broke into a house and killed Guy #2 in front of his children and wife. Killed him using a crowbar. Guy #2 managed to grab a butcher knife and fight back a little bit. Thus, we were treating Guy #1 (aka the murderer) for forearm lacs.

Emotion: Anger that this guy was alive. Later, my emotions were fear because I had to round on this guy every morning while he was in the hospital. I was so afraid to get close to him even with 2 armed cops in the room. I was also still angry because this guy kept asking me for extra blankets, special diets, etc. I wanted to say, "Kiss my red rosy behind" but I figured I better not. I was happy and relieved when they finally discharged him to prison.

Wow thats one crazy trauma story. I would have been freaking out when he came in. Thank you for the story.

 

[alpinism]

Pre-med: Rollover MVA w ejections. Car landed on top of dad, 2 children were thrown about 20yrs away stable but w multiple rib fractures and broken arms. We extricated dad and transported to the hospital, ended up dying in surgery from massive internal bleeding.

Emotions: Honestly, I remember being pissed that the whole thing didn't upset me more. I wanted to feel really bad but I didn't.

Med school: minor head lac (6 sutures) after a minor MVA. Nothing special.

 

[Bostonredsox]

as an MS3, first day of surg rotation.....stab wound to abdomen. PT literally walks into ED with hands across abdomen, loops of bowel hanging out in between them (nasty Z shaped deep stab pattern). trail of blood following him out the door down the street. Took him to surgery like 4 times that week. emotions..."wow, that ****s crazy, cool OR experieince initially, then boring with each susequent operation. He eventually died."

As a resident, the Peds traumas make me cry openly and I have to walk away. This is the reason I am glad I ended up IM/CC instead of EM/CC. otherwise the emotions are minimal. people come in jacked up and its our job to fix them. lets get to work.

 

[la gringa]

3rd year med school trauma rotation:
- pretty much an anatomy lesson of the groin on a guy who had his leg torn off in a motorcycle accident
- getting blood all over my face and hair when a surgery intern decided to empty the blood from a central line syringe into the kit i was holding (why? no idea. i was trying to be helpful b/c there was nowhere to put the kit!)

residency:
- it was all about the 3 B's: blood, beer, and BO... lot of drama. nearly all pts learned a lot about complex lacs and got helpful hints from surgery residents on central lines (including femorals on pulseless pts and another way to do subclavians).

 

[BJJVP]

I was volunteering at a trauma center in college when I witnessed my first trauma alert. I remember being kind of surprised at how the trauma surgeon could go from stressed out appearing, to pissed and screaming on the phone, to flirting with (or just sexually harassing) the trauma nurse.

The patient was in an MVA, unconscious, and had what I now know as a chest tube. I recall thinking that the atmosphere was not like the movies or "ER" where there are a bunch of medical people screaming and frantically scurrying all over the place. It was just the trauma surgeon, a trauma nurse and an anesthesiologist. It was a relatively calm scene. It was not gory at all...but it still kind of freaked me out because I grew up having rarely gone to doctors or hospitals.

What really stood out to me was how the patient didn't even seem like a real person to me. She was, of course, intubated and sedated. I had a nightmare that night about her finger nails. It was weird because she was an older lady, and I happened to notice her nail polish on the pulse ox probe as I helped get her off the CT scanner. I think that image must have stayed with me because that was the only human thing I noticed about her that day. I know it sounds completely silly to have a nightmare about nails in a really run-of-the-mill trauma pt...but you asked.

 

[dxu]

Paramedic here, pre-med to boot.

First trauma in the field I can't really recall.

But . . .

Most memorable and probably the goriest was a gentleman with EtOH on board who had his arm out the passenger side window while his not-so-sober friend was cruising down a back country road. Got too close to a tree and guess what happened? I arrived on scene and went to take a pulse in the arm. Couldn't find one and noticed the arm felt somewhat heavy and odd. Sure enough, total amputation at the shoulder taking part of the clavicle with it. Definitely gruesome. Went well with his open tib-fib fx as well.

 

[StevieStud]

I got brought along slowly.....

.... heard about a pt receiving CPR

.... walked by a room where CPR was being performed

.... stood in the hallway and watched CPR being peformed

.....stood in the room and watched CPR being performed

.....30 minutes into the code, you wanna give it a try, you can't do no harm

The same with just about segement of training and experiences.

By time it was my patient (my patient being relative to every level of training), the bad stuff had become second nature.

I feel sorry for those who get thrown into the wolves den on their first day... the emotional toll must be significant.

 

[K31]

Most memorable and probably the goriest was a gentleman with EtOH on board who had his arm out the passenger side window while his not-so-sober friend was cruising down a back country road. Got too close to a tree and guess what happened? I arrived on scene and went to take a pulse in the arm. Couldn't find one and noticed the arm felt somewhat heavy and odd. Sure enough, total amputation at the shoulder taking part of the clavicle with it. Definitely gruesome. Went well with his open tib-fib fx as well.

My most memorable trauma as a medic was similar. Car was coming down a mountain, and they went off the road and rolled about 100 yards down the mountain. The driver had a head injury and got flown. I was a baby medic at the time, so myself and my preceptor transported the passenger (driver's wife) to the trauma center by ground.

At some point, her arm had gone out the window and gotten trapped between the car and the ground as they rolled. Total hamburger from the elbow down. BP 70's systolic (she was very fluffy, but fortunately I was able to get in a decent line and give some fluids). Only time in EMS I ever applied a tourniquet.

 

[dsoz]

I was shadowing a physician at a trauma center when this patient WALKED in.

She was in the rafters of her barn when she slipped and fell. She landed straddling a stall wall. She fell off the wall into a pile of hay. She got up, walked to the house. Her hubby drove her 30 miles to the hospital.

She had compression fractures to T10-11. and there was a bone shard that was millimeters away from severing her spinal cord. Blood was squirting out her urethra (call to GYN to put in some stitches), but she was in good shape otherwise. That was one tough broad.

That same day there was a guy that came in with an atrial arrhythmia. I watched as they stopped and started his heart. I went home and told people that I watched a man die and come back to life that day.

These were on my first day of shadowing a physician...

The next time I shadowed a physician, it was a family medicine doc. His first patient came in with slightly elevated PSA, so I watched a prostate exam. Drop trou and put your elbows on the table. Hey dsoz, come look at these wonderful hemorrhoids...

The next time I shadowed the family doc, his first patient had warts on his junk that the doc was freezing off with liquid N2. The doc asked me to help him position the "member" so he could focus on the freezing. That was the first time I held another man's junk. Interesting.

Some of my family were joking with me that my luck would have a pelvic exam for my next "first patient of the day." Guess what! The next time I went into the doc's office, he told me to wait in the hall for the first patient because it was for an annual women's exam and she denied the presence of a student. (dodged that bullet for now).

Maybe not all trauma, but some of them were good stories.

dsoz

 

[dxu]

My most memorable trauma as a medic was similar. Car was coming down a mountain, and they went off the road and rolled about 100 yards down the mountain. The driver had a head injury and got flown. I was a baby medic at the time, so myself and my preceptor transported the passenger (driver's wife) to the trauma center by ground.

At some point, her arm had gone out the window and gotten trapped between the car and the ground as they rolled. Total hamburger from the elbow down. BP 70's systolic (she was very fluffy, but fortunately I was able to get in a decent line and give some fluids). Only time in EMS I ever applied a tourniquet.

What surprised me the most about the total amputation was how little blood loss there was. The body has a pretty cool way of protecting itself.

And that is a pretty cool story. Mine was younger medic too.

 

[corabrickdog]

Thank you everyone for the amazing stories!

 

[ER PA]

i work at a small town ER so all the serious trauma goes straight to the big city. the most trauma ive seen was a guy who was riding his 4-wheeler in the dark, and ran face first into a barbed wire fence. numberous deep lacs all over his face, including through his lips. somehow he got lucky, it missed his neck, and eyes. It was my 2nd week working, fresh out of PA school. i went to the supervising physician like, "so this guy ran his face into a barbed wire fence, so where do we send him? or do we need to call in a plastic surgeon or something?" the physician looked at me like, "um, YOUR the plastic surgeon".. i spent nearly 3 hours sewing his face back together. Afterwords his wife was so grateful about how good it looked, she gave me a hug. Pretty cool experience

I was a little grossed out at first, but really the biggest emotion was gratification, to be able to instantly "fix" something like that, is pretty amazing.

 

[e30ftw]

dont really remember my first trauma experience, but a couple i remember from EM/trauma in med school..

the ole "shot gun to the face" that is angled too far anterior and misses the cranial vault but gets the jaw/face... those are pretty ugly.

mcc w/ traumatic leg + arm amputation in field..

mvc traumatic arm amputation and traumatic ICH on a young girl.. the part that gave me the chills back then was seeing the belly button ring and nicely done toe nail polish on someone who most likely wasn't gonna make it.

 

[eastcoastEM]

I don't remember the first but I'll always remember my worst so far, which began with cutting off the young lady's scrubs, which were the same pale blue color as mine.

 

[NinjaBunny]

I don't remember the first but I'll always remember my worst so far, which began with cutting off the young lady's scrubs, which were the same pale blue color as mine.

Come on now.. You can't start a story like that and not finish it!

 

[engineeredout]

If we're going with grusome, Methane gas explosion. Two workers inside. Both flown in with > 95% TBSA. Came in awake and talking too which was the most ****ed up part.

All sorts of feelings. Being part of the initial treatment was awesome. Got to do escharotomies with a bovie in the unit room. Everyone so concerned about the burns but we still had to treat as a full trauma pt because these guys got blown out a window. Actual gruesomeness of it didn't bother me.

Following for the next few weeks not so awesome. Tons of work, tons of dressing changes and grafting and distraught families. Town mayor visited frequently. Knowing these guys would never be anywhere close to the same even if they survived.

Never regained consciousness, both died after 4-6 weeks in the burn unit from infections. Feels like man, why did we even bother?

 

[CajunMedic]

Didn't really get much trauma as a basic, but as a relatively green Paramedic in a rural area, I seemed to get a bunch.

Got called to a hunting lodge on a fall, turns out a man had fallen from an interstate bridge that crossed the reserve. 30 foot fall onto outstretched hands. Open right radius/ulna fx with the bone ends driven into the mud, open book pelvic fx, completely disarticulated left elbow with distal humerus exposed, right femur fx. Had to immobilize him and ride in the bed of a Kawasaki mule with him to the ambulance, BP 60/0, and hypothermic. Got an IV by the grace of God, and put him on the helicopter for the hour flight to the trauma center. He called and thanked me 6 months later for saving his life. Turns out in addition to everything above, he also had a C4-C5 fx, ruptured spleen, lacerated liver, and bilateral pulmonary contusions.

It's been downhill from here as a medic, I can only imagine what it's going to be as a physician.

I was scared initially, but forgot about the fear once we got to the patient. The was a sense of relief once the chopper took off and I knew he was going to the trauma center.

 

[migm]

As a highschooler volunteering in a Level 1 ER, had just come in for my first shift to grab warm blankets and sortof stay out of the way. Had a huge hospital breakfast and saw a guy come in after falling under his lawnmower on some dewey grass and amputate about half of his foot off yelling his ass off. I figured if I could handle that then I could handle medicine and EM ... and here I am

(insomnia is no fun)

 

[glorfindel]

I was an EMT student, spending a few hours in the ER as part of the course.

Some yahoo across town walked into a biker bar with a semiautomatic rifle ("assault rifle") and started shooting. Dude goes back out to his car to reload and a cop shoots him in the head with his handgun.

EMS brings to us: 1) two of the victims, both shot in the face, and 2) the shooter.

Victim #1 has most of the soft tissue of his neck blown off; can see the white, white tracheal rings plain as anything. Looked like one of the corpses in "an american werewolf in london." Amazingly, the big cervical vessels were intact.

Victim#2 I didn't see

The Shooter: he had an easily palpable, intact slug lodged under his scalp and above the skull. Seems the bullet hit him so obliquely that it just slid along the skull under the skin without popping through into the brain cavity.

Everyone who arrived at this hospital survived. Several dead on scene though.

That night was when I first thought about going to medical school.

 

[glorfindel]

Following for the next few weeks not so awesome. Tons of work, tons of dressing changes and grafting and distraught families. Town mayor visited frequently. Knowing these guys would never be anywhere close to the same even if they survived.

Never regained consciousness, both died after 4-6 weeks in the burn unit from infections. Feels like man, why did we even bother?

That's why I'm an ER guy, not an inpatient guy.

 

[The Undecider]

It wasn't super gory or anything but the first couple of times...man...my only job was to take a blood pressure and I was just proud I heard it through my hands shaking and the ruckus of everything going on.