I'm a pre-med wondering, how did you first react to the sight of major trauma?

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greatnt249 said:
Is it the sight of the trauma itself, or the idea that you will be in charge of salvaging the trainwreck that scares you?
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Haha, good point. Both, really. But getting over the initial fear of trauma itself. I don't plan on being an ER doc, but I'll have to deal with it at some point. I'm just scared I'll pass out. I almost fainted at the sight of roadkill. Granted, it was a golden retriever, not a raccoon, but still.
 
Although I'm only a pre-med I have seen lots of trauma volunteering in the ED at a level 1 trauma center.

The first time that I was in a trauma bay, a guy came in who was selling some meth on an overpass, and the deal went wrong. He got shot in the back twice then jumped off of the overpass. You can imagine how this guy looked coming in..

In the minutes before he came in, I felt very nervous and had a slight feeling that I might pass out. When the guy came in, my head really cleared up and I was like "whoa, this isn't so bad". I realized that seeing the trauma was actually less stressful than the anticipation I had before he came in.

So in other words, in my experience, the initial fear of my reaction to the trauma was actually worse than seeing the trauma.
 
Rocher said:
I realized that seeing the trauma was actually less stressful than the anticipation I had before he came in.

So in other words, in my experience, the initial fear of my reaction to the trauma was actually worse than seeing the trauma.
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It's this. Although in some ways I'd imagine it's worse to be the med student, who can only stand there and watch while the trauma team does its work. It's much easier to deal with when you've got a task to focus on.

Oddly enough, all of the above goes for gross anatomy lab, too.
 
weirdly enough, i also felt like seeing trauma situations was easier after sitting and dissecting in the anatomy lab for a semester. maybe your gross tolerance goes up after working with cadavers...
 
The first time is usually the worst. You'll get desensitized pretty quickly. It's not that you won't have a bit of a shock or a sympathetic response but you'll learn to control those emotions and react appropriately. I think observing how others handle the situation helps.
 
I was one of the first responders to an MVA where one of the passengers got ejected and the SUV rolled on top of him. It didn't affect me too much at the time, but it took me a little over an hour in bed to get to sleep that night (happened at like 3 am). Was worried I'd suffer some trauma from it, but nothing ever really came of it, was just like a bad dream.
 
It can be somewhat surreal, almost dreamlike, especially if the patient is conscious. An open ankle dislocation was my first. Needed to be reduced..non-sedated. Blood everywhere, patient howling, couple onlookers giggling, it was just so bizarre and other-wordly it can't be described.

Gross anatomy will NOT prepare you for that, nothing can except maybe war.
 
While volunteering for the FD one day, I was on standby while a 4 year old got airlifted for burns. He wasn't even that badly injured (he was conscious and looked calm) but the psychological impact of seeing his family worrying for his safety while the helicopter flew away was intense.

I don't mind the sight of blood or minor trauma, but I haven't seen any major mutilations yet in my life, and I'm sure it'll definitely leave a big impression.
 
My first trauma was when I was volunteering in the ER. Full blown code in the trauma bay. I was hesitant to go into the room (after all, volunteers were supposed to stay out of the room when codes were happening) but one of the ER docs said something to the effect of "You need to see this, get in there" before shoving me with two hands into the room.

Turned out it was a guy who had fallen a hundred feet. Had come into the ER with no pulse. Bloody, a big mess. Was pretty surreal. I remember after 10 or so minutes the doctor running the code asked the nurse how long he had been "down" for, the nurse said 10 minutes. He stopped what he was doing, removed his gloves and said "somebody call it" before walking out of the room.

I think I had mentally prepared myself before volunteering in the ER that I might see some bad things, including horrible injuries or deaths of patients, but to see the real thing was quite another thing. Was a bizarre experience. Will never forget it.
 
Surreal. That pretty much describes it. It's the food of dark humor later. At the moment, you just perform your role. The PTSD stuff can come up later if you don't handle the stress well, though.
 
If anytime you find yourself unable to mentally cope with what is going on revert back to the very basics of your training.

I've seen and have had a couple of very nasty trauma patients in my brief time in EMS. By far the first initial seconds of time almost stands still then I generally focus on nothing but the pt and then reflect back later.

Worse: Driver in a Ram 3500 truck T-boned a family of four in an old subaru at an estimated speed of 70 mph.

Most gruesome: Not kidding you, but skydiver who had equipment failure and we were basically called out of panic as there was no medical need..
 
Just head on over to some gore sites and watch some videos/pictures while eating food. You'll get use to it real quick. 😉
 
Mithril said:
First real trauma that I saw was someone committing suicide by jumping on the monorail tracks on May 4, 2007 just a few metres from me. There was blood and bits of human flesh in the corridor in front of the train. My breathing gets really shallow even when I think about it today. It's not something you ever want to see.
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What's known as a "person under train" incident is even worse for the transit operators. Especially fixed-rail vehicles like trains/subway cars where the operator may see the entire incident unfold and cannot do anything to stop or swerve. It's very traumatic to be used as the agent of someone else's destruction. 👎

And I'm not sure I should even mention the low-clearance (or even... no clearance) tunnel scenarios... The "scene" can spread for hundreds of feet.
 
ILikeDrugs said:
Just head on over to some gore sites and watch some videos/pictures while eating food. You'll get use to it real quick. 😉
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I'm sure you're kidding, but I do this a lot. It used to bother me a lot watching gross videos while eating, but now I'm really desensitized to that stuff. Granted I haven't seen a real trauma in real life but I feel like I've seen some of the worst the internet has thrown at me and I'm ok seeing roadkill and dead puppies. You really don't know gruesome until you see the video of these dudes grabbing a homeless man and basically super torturing him to death with hammers and screwdrivers. Take my words for it guys and don't look it up.
 
There's a difference between tv and reality. I can't stand watching it on tv, because I have time to think about it and I start to think how the patient must be feeling. And I'll think about how much that must hurt and all that girly stuff...

However, when I was younger there was a nasty accident that happened in front of me. It cleared my head and I was logical, calm...not bothered by the "bits" everywhere. Focused on having the situation in control. Rather empowering experience for me. Actually, it's one of the reasons I know I want to be a doctor.
 
SuperHiro said:
The first time is usually the worst. You'll get desensitized pretty quickly. It's not that you won't have a bit of a shock or a sympathetic response but you'll learn to control those emotions and react appropriately. I think observing how others handle the situation helps.
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/agree!

For me it's the smell, other than that it "looks" hollywood. I worked @ Travis AFB which had the Mortuary services for the entire west coast and the Pacific (Japan, Hawaii, Alaska, etc...). We recieved a young man who committed suicide 7 days prior by hanging in his hotel room. Displaced broken neck, Y incision hastily sewn with large gauge thread, everythng from about waist down was purple and much larger than normal from the blood pooling in the lower extremeties from gravity as he hung in his room for 4 days.

The oral mucosa was runnier than paste when we took the forensic xrays on his, i remember having to squeege the tissue off with my hand and flick it on to the floor (3nd nastiest thing i have ever had to do working there). But the killer, the smell. Its almost like your body KNOWS that it's smelling what it will smell like someday. Completly replusive...all i ate for 2 days was chips ahoy.(It's all i could stomach)

Now trauma usually smells "tinny" or to me like copper, due to the blood. When blood dries it has a certain smell to it. But that doesnt really bother me anymore.

We have had heads in clinic to allow the surgeaons to practice recon surgeries on. Heck, i took an Air Force ambulance to UCSF to pick up 4 hads and 2 bodies for our facility one time. My commander asked me to stay late to help him one day...we waitied until the residents left to round and i ent into a room with 4 heads covered by towels sitting on the side table. He was holding a sledge hammer. He simulated various Lefort fractures (I, II, III) with the sledge-i was holding the heads while he whacked away. He did a little creepy shiver after each hit, i just grinned and held on.

I've seen attempted suicides, beatings, MVA's (motor vehicle accidents), helicopter crash remains, cadavers, various detached parts of the body hanging out on scales inthe lab and such (foot, diabetes) and it all gets pretty routine.

You get desensitized to it if you allow yourself to be. Just look at the person as a human with needs that you are trying to fix! Imagine yourself there and for me it makes overlooking the sheer gravity of the trauma bearable.
 
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Buttermellow said:
I was just thinking that it might scare the **** out of me in the future, never having seen any sort of major trauma. Your experiences?
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the first week volunteering in the ER they had a cardiac arrest and I asked to watch as they were coming in (they let me stand in the corner during traumas).. guy died and choked on a pizza, afterwards I went for an honorary slice of pizza with my mom

second week of volunteering I come in at 9AM and guy was dead and already in the body bag... they only had one male nursing assistant so I ASKED if they wanted help with the dead body.. helped bring the dead body down to the freezer, touched his elbow ect. (how many pre-meds can say they touched a dead body?)

few weeks later lady gets run over by a car major trauma and her head is gushing blood (standing in room ect.) and I thought it was great how all of the doctors worked in a team ect... I'm not sure if they saved her or not but i was helping bring pumps into the room and an oxygen tank... simlataneously there was a 90 year old cardiac arrest that got CPR for a while via phone instructions but idk..

first time i saw a trauma i was interested\excited and didnt mind the blood at all.. it was "fun" even though thats not the right word. I asked to go in because whats the point of being in the ER folding blankets and pillows all day if you're not guna see some real god damn ****. lololololol... im thinking of doing pediatric EM but sometimes it is so boring with nothing exciting just broken bones ect. and the flu of little kids... thats why im prob guna do neonatology everyone needs major help and there are emergencies all the time. saves the most life years too
 
My first trauma was an interstate rollover on my first day as an EMT-B. Five patients, three EMS personnel.

My reaction was to realize I had been pretty well trained.
 
ILikeDrugs said:
Just head on over to some gore sites and watch some videos/pictures while eating food. You'll get use to it real quick. 😉
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Haha I've done this to desensitize, too.. also with a boatload of online surgeries
 
I agree with everyone about the surreal feeling, slow motion almost. Seeing family members' reactions is much worse than the trauma.
 
Like others have said, you get over it rather quickly. I had one of those "surreal" moments when I witnessed all of a patient's blood entering a heart/lung machine for the first time. Trauma wise, nothing has really bothered me too much.
 
Pediatric ED, gunshot wound to the head. I definitely agree with the mentions of it being surreal and feelings of helplessness as a silly little pre-med with no responsibilities related to the case (the ER attending told me to observe). After the physician called it with the parents there was bad and I shed a few tears. And then I went back to work. Of course, I thought about it during breaks for the next few days, and every so often now when the issue arises.
 
Mithril said:
First real trauma that I saw was someone committing suicide by jumping on the monorail tracks on May 4, 2007 just a few metres from me. There was blood and bits of human flesh in the corridor in front of the train. My breathing gets really shallow even when I think about it today. It's not something you ever want to see.
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I am incredibly sorry you had to witness something like that, I got chills down my spine just imagining being in a position like that
 
BJJ said:
You really don't know gruesome until you see the video of these dudes grabbing a homeless man and basically super torturing him to death with hammers and screwdrivers. Take my words for it guys and don't look it up.
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God, that is just sick. Some people must truly feel no remorse and have no conscience. I'm not usually a fan of the death penalty, but I might change my mind about that in some instances.
 
You become desensitized to everything pretty quickly, once it becomes routine. Seeing the reactions and emotions of those involved is much more taxing on my mind than dealing with the trauma itself. However, I'm basing that on experience from a firefighter/emt perspective.

You just have to refocus and remind yourself that you have a job to do and keep on that mindset for the sake of the patient.
 
I have no issue with with any major trauma, gash, or blood. BUT double jointed fingers sends shivers down my spine. makes my feel like my own fingers are very vulnerable.

ironically ortho is my main field of interest in medicine.
 
Trauma doesn't bother me. Honestly, whenever I'm in the ED or OR I get a little of that excited feeling you got as a kid waking up on Christmas morning. Blood and gore hasn't ever phased me. And say what you will, but I eat lunch while looking at some nasty stuff for the medical journal I work for. Though after observing surgery...I'm more apt to have a salad than something with meat.

However with that said, there is something that will just creep me out and send shivers down my spine...and that's worms. Gross gross worms. Uhg, just gave myself shivers.
 
Honestly I just look at it as, although tragic, something kind of cool in a way. All traumatic injuries are unique and the idea of figuring out how to solve something no one has ever been faced with fills me with more fascination than disgust.

Check this out if you want to test yourself- http://www.davesems.com/Injuries.html
 
Teenage girl's brother had whacked her in the head with a machete. She was split pretty badly. I stared.

From Catch 22 by Joseph Heller, Snowden's secret: "Man was matter, that was Snowden's secret. Drop him out a window and he'll fall. Set fire to him and he'll burn. Bury him and he'll rot, like other kinds of garbage. The spirit gone, man is garbage."
 
Who's been in a delivery room? Most amazing/scary thing ever to witness a birth of baby. Mine was in Bolivia to top it off.

It wasn't a major trauma, but it sure did sound like it...
 
i want to be a surgeon. yay for blood and guts. i watch surgery videos on youtube while i eat. i have the toughest stomach because i don't get nauseated as i watch.
 
ILikeDrugs said:
Just head on over to some gore sites and watch some videos/pictures while eating food. You'll get use to it real quick. 😉
Click to expand...

This is true. One of my older friends showed me to such a site when I was in middle school. I don't ever remember being so scared and vowed never to go on there again. Curiosity got the better of me, however, so I ended up going through the entire site. After a while I was used to seeing such images.

Of course, seeing a mutilated corpse online is WAY different than seeing one in real life. Still, it somewhat prepares you for it. The first time I saw a dead person (road accident), I wasn't too affected by it, probably due to my exposure to such stuff on the web.
 
BJJ said:
I'm sure you're kidding, but I do this a lot. It used to bother me a lot watching gross videos while eating, but now I'm really desensitized to that stuff. Granted I haven't seen a real trauma in real life but I feel like I've seen some of the worst the internet has thrown at me and I'm ok seeing roadkill and dead puppies. You really don't know gruesome until you see the video of these dudes grabbing a homeless man and basically super torturing him to death with hammers and screwdrivers. Take my words for it guys and don't look it up.
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Did you guys really just let this slide?
 
Every once in a while, I get a little uncomfortable seeing traumas. It's just something that you work through.

The most difficult thing that I've seen was a little boy die. When you have children, you think things like, "what if that were my little one." Heartbreaking.
 
It's different for everyone. My first trauma to deal with was a girl who had cut her thumb off in my apartment building. Was her first reaction to rush to the doctor? Nope. She came to my apartment, remembering that I was "medically trained" (read: first aid, CPR, knows when to call for an ambulance; that's it), and asked me to fix her hand.

I should've panicked. I'm still surprised I didn't. She just lifted her hand to show me what she'd done, held up the severed thumb in the other, and I just felt this sudden calm. I put her thumb on ice, got some gauze to hold over the stump, and took her to the hospital. After she was out of sight and I had time to think about what had just happened, I spent a good minute or two dry-heaving in the ladies' room and washed the f*ck out of my hands.

But ever since, I don't react much. I think I'll always react later; my initial response is always calm.

But it's not that way for everyone. I know someone who passed out the first time he saw something awful, and another who got halfway through helping someone with a broken arm (bones visible) before having to dash off and vomit.

So you really can't predict what'll happen.
 
I can't remember my first time with trauma (having lived in a third-world country, I am sure it was when I was young), but the most influential one was an airplane crash. The pilot was in such bad condition. I was only a volunteer, but since they had no one to get blood, I ran to the lab and got blood, in turn they let me watch everything up-close and personal. The pilot is still in ICU, 6 months later. And I'm sure some of you have deduced that there is not much of him left, except his family keeping him going on machines. But I agree with everyone, if you have a task, you are more focused on that than getting grossed out. I also work as a nursing assistant, and have several codes/rapid responses called on my patients. I always try to keep myself busy either hitting the button for vitals, etc. Otherwise I too become nervous and uneasy. (But that could be attributed more to the fact that it's my patient they are working on).
 
I've never seen a traumatic event occur, but I've seen the results of one. It's pretty surreal the first time, but I didn't feel like I was going to do anything terrible like pass out or puke or whatever. You just kind of go, "Whoa, I'm digging around in this dude's femur" and go about your job...of holding stuff in place while while the people who matter and know what's up work. 😛
 
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