Had a very bad call last night.
The red (critical) zone is usually very quiet when I am on duty there. However, last night was a completely different story.
At 10.15pm, we received a call to inform us that a polytrauma (accident) case was coming and code blue was activated.
* code blue is the code to call when there is a major trauma case whereby multiple departments (i.e. general surgery, orthopaedics, neurosurgery, anaesthesiology, ENT & dental) will be called for standby and they would attend to the cases together with the ED team as soon as the patient arrives.
At 10.20pm, while we were still waiting for the major trauma case, we received another call that another accident case was coming in.
Then all hell broke loose.
The two accident cases arrived simultaneously, closely followed by a neurosurgical case from Hospital Klang… Then I just lost track of what other cases came in. It was truly a chaotic period in our red zone.
Everything went in a blur. I remember having to run to the blood bank for blood products… I remember having to bag a patient before passing it over to my friend and intubated another patient… Then I went back to bagging the first one… Then had to do CPR on another one… And back to bagging the first one… I can’t even remember what I did to whom and who suffered what injury.
I was extremely grateful that the orthopaedic house officer on call was a good friend of mine who did not mind helping me out from taking blood (the paramedics were too busy to help us with that) to doing CPR and bagging the patient. The surgical house officer simply disappeared.
Don’t let me start ranting about these new generation of housemen! When I was in the surgical department, I was the one who ran for bloods when there was a trauma patient with intraabdominal injury. I helped the ED team do CPR, take blood, set lines and whatever other things that I could help. After all, the patient was mine too. Nowadays, the ED team does everything. The orthopaedics and surgical housemen are usually nowhere to be seen.
Anyway, since code blue had already been activated, all the respective teams were already in the red zone when another accident case was pushed in. Instead of being attended by the ED team, he was first attended by the anaesthesiology specialist, followed by the ENT medical officer! Then we just sort of yelled, “Code blue! Code blue!” (without having to go through the call centre)
It was as if we were having a party in the ED… a TRAUMA party.
The others left as soon as they have done their parts but it took us much longer to settle our parts… i.e arranging for beds, stabilising the patients and sending them up to the wards/ ICU. It was not until at 4am when we finally realised that we had not documented anything on the first accident patient that we attended to… Even though other departments (that was involved in the code blue management) had already signed in their notes.
It was so hectic my MO didn’t even realised that there was a neurosurgical case (who was attended by me) and that our second accident victim had already went up to the ward.
Needless to say, I was a bit ‘off’ this morning as my usual post-call euphoria was a bit more compared to the usual one and I was smiling, laughing and dancing away despite having a bad call. My MO commented, “Nuni, you’re nuts! Are you sure you didn’t take anything (substances like drugs)???”
One of the accident cases last night was an interesting one… One car tried to avoid something (the victims were attended to in the yellow zone) and skidded before overturning several times into the other lane. Another car from the opposite direction crashed into the previous car and according to the driver of the second car (also sent to yellow zone), the first car ‘flew’. He did not remember anything else. He was clinically relatively stable. However, his friend who was sitting at the front passenger’s seat was sent to red zone. He died.
To make things more exciting, seeing that there was an accident and an ambulance was already there attending to the victims, a motorcyclist decided to slow down to have a look at the car registration number so that he could buy a winning lottery number scene and was hit by another car. I think he was triaged to green zone.
Moral of the story? Do not slow down when you see an accident. You might get involved in one yourself.