2006-09-30

Friday Call

So, as weekend calls go, a Friday call is generally considered to be pretty sweet. Spend the day with the team, take pages (and in the case of the surgery team, traumas) overnight, round at 8am, help the incoming student with notes and cleaning up scut, which is minimal on the weekend, and out of there usually by 1030 or 1100.

Which all falls apart when there is no incoming student.

It was actually a great call. Sort out minor stuff till 2300, then grab a few Z's. Until the trauma pagers (all 7 of them!!) start to go crazy at 0315: "trauma team to trauma room." Rub the sleep out of the eyes, grab for glasses, what did I do with my shoes?

Shoes located, down 18 floors to the trauma bay.

Pedestrian vs car high speed. Head injuries. ABCDE, X-ray, CT everything, get a reading from an unhappy radiology resident, ICU, neurosurgery consult, ortho consult. Whew!

When it is clear that our patient is well taken care of, back to 18 to sleep a little more.

Wake up to a change in the light. The rising sun is red red red. Clear sky to the north and south, but the view from our window looks east over the city, and a low black cloud like smoke is obliterating the sunrise and the city and sending chills down my spine.

The door bursts open and a nurse says, "Your patient is in trouble, come now!"

A lady with a bowel obstruction having conservative management has had sudden onset of excruciating abdominal pain. She has been doing well until now.

Vitals, morphine, stat abdo series, draw bloods and ABG. Is that hernia reducible? Is the NG working? Could she have a clot? What are the vitals now? Will a CT help?

0800 finds the senior resident and the medical student rounding. The trauma junior who has just finished his parachute call in ICU takes pity on us and helps us with the notes and orders (cool, thanks). When there's really very little left, he leaves, to get a well-deserved sleep.

And as I am running through the labs, *beep, beep, beep* "trauma team to trauma room." Technically I don't have to go, but I came to do trauma.

18 floors down. Elderly lady, apparently run over and dragged by a car. Driven by her elderly husband. He is devastated; he didn't see her. ABCDE, X rays. Pelvic fracture, needs wrapping. Hypotensive. Angio or CT?

Back to the floor, finishing up. Call the junior to let him know about a couple of minor issues which can only be cleared up by someone who can order medication, and he says "Pre-Code Orange (Disaster): a bridge in Laval has collapsed; there are definately injuries and some people might be heading our way." Oh no! Okay, I'm sticking around then.

Back in ED, take the down time to suture up a big laceration on someone's leg.

Eventually, we find out that all the injured people have been sent to the other trauma centre. And by now it's 1600. Back to the floor to tie up loose ends, then call the senior with an update. He asks me to check on one more thing, and then sends me home to sleep. Or eat, actually.

And then I went for crepes with my husband.

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