My last week in Sacramento, in addition to trying to pack and get everything back in my car, I was sent follow a resident in the Emergency Department. This service is especially difficult because its patients range from the mentally agitated to those in car accidents. While the interns may only have to cut away clothing, someone must be ready to open the patient. The cases I saw, in quick succession, give a hint of the diversity one resident had to deal with the same evening.
Case number one: an adult male, previously treated for injuries sustained when he fell of his bicycle a week earlier. Had been sent home with broken ribs. Difficulty breathing brought him back. Imaging showed a light region where the lung should be. He had developed a hemopneumothorax. Blood and air needed to be removed, if not successfully in the ER then by a surgeon. Under local anesthetic an incision was made and the whisper or air was followed by gurgling blood. He was sent home with a chest tube.
Case two: teenage girl on bike hit by car. Imaging shows no internal injury but a large wound to her left thigh needed debridement and dressing.
Case three: 20 month old boy bitten around the right eye by pit bull. No one saw the attack. The mother carried the screaming child in. Once calmed by medication, images were taken to look for fractures to the skull and facial bones. The wounds were deep punctures, probably needing eventual cosmetic repair.
Case four: adult male with continuous abdominal pain since previous evening’s meal. All symptoms point to blocked gallbladder…he was the only one scheduled for surgery.
Every case gave me a little more knowledge about some system in the body which I’ll now be able to weave into my anatomy lectures. Classes start next Monday so my summer of shadowing is over. If you ever get a similar opportunity, I encourage you to take it…but not if it involves renting an un-airconditioned room in Sacramento for the summer! Teri