Bang Bang
Interesting night at work last evening/this morning. It was pretty quiet until after 3 a.m. or so, just a few people looking for narcotics and one woman with an infected knee status post left knee replacement, and then the trucks began arriving. The first was a stab wound, followed by two gunshot victims, all of whom were in extremis and near death. The stabbing victim required a thoracotomy, which is the fancy word for cracking the chest with a huge incision from the sternum to the flank and rib spreaders. He had a puncture to the left ventricle, which caused the fibrous sac around the heart to fill with blood and clot. The right ventricle, visualized with ultrasound, collapsed from the pressure. He lost his pulses until the surgeon released the pressure by opening the sac and cleaning out the clotting blood. Blood spilled all over the trauma room floor, and the process attracted a huge amount of attention from the staff. I’ve never seen anything like it. He quickly went to the OR and was stable but critical this morning in the cardiac ICU.