(no subject)
WARNING: The following is an entry about something rather traumatic that happened to me last Sunday. It happened while I was at work, and I work at a children's hospital. Which means it involves something bad happening to a child. Be forwarned that it might be upsetting to some.
"Any suggestions?"
The resident looked up at her attending, blowing a lock of hair out of her face and shrugging as best as she could while doing chest compressions. She nodded at the intern standing beside her, who leaned in and took over the rhythmic pounding, eyes locked on the monitor to ensure adequate circulation. Dr S sighed heavily from the opposite side of the trauma room, looking between the bloodied gurney and the bleak X-ray on the screen in front of her.
The thunder crackling outside was barely a rumble deep in the belly of the ER. The torrential rain outside meant that most people were staying home, leaving the ER beds free for people who really needed them - mostly flu-like symptoms and asthma attacks, with the occasional sickle-cell crisis or cancer patient with a fever. For a Sunday, it had been relatively quiet. Not anymore.
The call had come in at 1320 - a two-car MVA on C Street with critical injuries. A pocket-sized Toyota had hydroplaned in the rain and crashed into a heavy pick-up truck before slamming into a guard rail. Paramedics were transporting one trauma to the ACH ER. Unrestrained passenger in the front seat of the Toyota. Age unknown, assumed to be under the age of 10.
The trauma team had assembled in fits and starts, taking up their usual spots in the cavernous trauma room. The respiratory therapist at the head of the bed, turning on the O2 for the Ambu bag and prepping the intubation tray. The pharmacists along the east wall, notebooks in hand. The high acuity nurse at the table, flow sheets opened and ready. The attending, Dr S, and the resident, Dr M, waiting at the bay doors, while the interns waited in the room with the nurses. The chaplain and the social worker in the hallway exchanging pleasantries as they cleared the path for the radiology techs to maneuver the portable X-ray machine into an empty spot along the wall.
The paramedics, all soaking wet from the rain, had brought in the stretcher, calling out details. They had lost the pulse en route, and the smallest of the three was perched atop the bed, compressing as they rolled. She had climbed off as they transferred the child to the trauma bed, where a waiting nurse started compressions again. Dr M had listened to the bloodied chest with her stethoscope while nurses checked peripheral pulses, which hadn't been found. The respiratory therapist had moved to the side of the bed while Dr S navigated the laryngoscope through blood and broken teeth, elevating the jaw and attempting to guide the endotracheal tube past the vocal cords. One of the nurses had stood nearby with suction and damp towels, clearing the blood, water, and brain matter away from the face so the doctors could work.
Now, almost 17 minutes into the code, Dr S sighed heavily and studied the scene. The battered little body, surrounded by people in yellow protective gowns, their gloved hands covered in blood.
"Halt compressions," she said. "And listen."
Everyone pulled their hands away from the little boy and Dr M pressed her stethoscope to the eerily still chest. Looking up, she shook her head.
"Calling," said Dr S. "Time of death 1402."
The non-ER code personnel gathered their belongings and made their way toward the door as the high-acuity nurse frantically scribbled information on her flow sheets. Two techs began clearing away the towels and discarded equipment wrappers as Dr M folded the thin brown arms across the chest and pulled the a over the body. The respiratory therapist wiped the last of the blood away from the face and the chaplain said a prayer from the doorway.
"Do we know who he is yet?" asked Dr S, pulling off her yellow gown and gloves.
"Yes," said the social worker, stepping toward the bed. "His name is J. He was in the car with his mother. She's at University Hospital, but it doesn't look good for her, either. Dad is here, in the Family Room."
"I'll speak to him," volunteered Dr M.
Dr S shook her head, running a hand through her graying blond hair. "No, I'll do it." She turned back to the bed. "Do we know how old?"
"Eight."
"Eight," repeated Dr S. "Damn."
The social worker nodded. "I put in the call to the coroner. Do you want to let the family in now?"
"Yeah, we probably should. As long as they know not to touch him yet." She sighed. "You said they're in the Family Room?"
The social worker nodded again. "The chaplain is outside waiting for you."
Dr S looked once again at the bed. "Good work, everyone," she said.
"Any suggestions?"
The resident looked up at her attending, blowing a lock of hair out of her face and shrugging as best as she could while doing chest compressions. She nodded at the intern standing beside her, who leaned in and took over the rhythmic pounding, eyes locked on the monitor to ensure adequate circulation. Dr S sighed heavily from the opposite side of the trauma room, looking between the bloodied gurney and the bleak X-ray on the screen in front of her.
The thunder crackling outside was barely a rumble deep in the belly of the ER. The torrential rain outside meant that most people were staying home, leaving the ER beds free for people who really needed them - mostly flu-like symptoms and asthma attacks, with the occasional sickle-cell crisis or cancer patient with a fever. For a Sunday, it had been relatively quiet. Not anymore.
The call had come in at 1320 - a two-car MVA on C Street with critical injuries. A pocket-sized Toyota had hydroplaned in the rain and crashed into a heavy pick-up truck before slamming into a guard rail. Paramedics were transporting one trauma to the ACH ER. Unrestrained passenger in the front seat of the Toyota. Age unknown, assumed to be under the age of 10.
The trauma team had assembled in fits and starts, taking up their usual spots in the cavernous trauma room. The respiratory therapist at the head of the bed, turning on the O2 for the Ambu bag and prepping the intubation tray. The pharmacists along the east wall, notebooks in hand. The high acuity nurse at the table, flow sheets opened and ready. The attending, Dr S, and the resident, Dr M, waiting at the bay doors, while the interns waited in the room with the nurses. The chaplain and the social worker in the hallway exchanging pleasantries as they cleared the path for the radiology techs to maneuver the portable X-ray machine into an empty spot along the wall.
The paramedics, all soaking wet from the rain, had brought in the stretcher, calling out details. They had lost the pulse en route, and the smallest of the three was perched atop the bed, compressing as they rolled. She had climbed off as they transferred the child to the trauma bed, where a waiting nurse started compressions again. Dr M had listened to the bloodied chest with her stethoscope while nurses checked peripheral pulses, which hadn't been found. The respiratory therapist had moved to the side of the bed while Dr S navigated the laryngoscope through blood and broken teeth, elevating the jaw and attempting to guide the endotracheal tube past the vocal cords. One of the nurses had stood nearby with suction and damp towels, clearing the blood, water, and brain matter away from the face so the doctors could work.
Now, almost 17 minutes into the code, Dr S sighed heavily and studied the scene. The battered little body, surrounded by people in yellow protective gowns, their gloved hands covered in blood.
"Halt compressions," she said. "And listen."
Everyone pulled their hands away from the little boy and Dr M pressed her stethoscope to the eerily still chest. Looking up, she shook her head.
"Calling," said Dr S. "Time of death 1402."
The non-ER code personnel gathered their belongings and made their way toward the door as the high-acuity nurse frantically scribbled information on her flow sheets. Two techs began clearing away the towels and discarded equipment wrappers as Dr M folded the thin brown arms across the chest and pulled the a over the body. The respiratory therapist wiped the last of the blood away from the face and the chaplain said a prayer from the doorway.
"Do we know who he is yet?" asked Dr S, pulling off her yellow gown and gloves.
"Yes," said the social worker, stepping toward the bed. "His name is J. He was in the car with his mother. She's at University Hospital, but it doesn't look good for her, either. Dad is here, in the Family Room."
"I'll speak to him," volunteered Dr M.
Dr S shook her head, running a hand through her graying blond hair. "No, I'll do it." She turned back to the bed. "Do we know how old?"
"Eight."
"Eight," repeated Dr S. "Damn."
The social worker nodded. "I put in the call to the coroner. Do you want to let the family in now?"
"Yeah, we probably should. As long as they know not to touch him yet." She sighed. "You said they're in the Family Room?"
The social worker nodded again. "The chaplain is outside waiting for you."
Dr S looked once again at the bed. "Good work, everyone," she said.