I was the backup trauma nurse that day, we had 3 traumas coming in at the same time. One was a green (not so sick), one was a yellow (ok, kinda sick), and one was a red (pucker factor!). The trauma team leader took the trauma red, I took the trauma yellow, and a third nurse came to assist with the trauma green. I got radio report that a man had been riding his bicycle through a tunnel, had been hit by a semi truck, had a leg injury, vital signs stable. My first thought was “Really? Hit by a semi truck and just has a leg injury? This should be interesting.”
Of course all 3 traumas arrive at exactly the same time, which immediately creates a little chaos. My patient comes in, laying on a gurney and wrapped in a large yellow tarp that had been used to pick him up off the road and loaded into the helicopter. I make eye contact with him, introduce myself over the noise of the trauma bay, and quickly glance at his vital signs which are rock solid. Several staff members help move him over to our trauma gurney. The emergency room doctor is at the bedside, and we immediately begin our assessment: airway clear, spontaneous breathing present, radial pulse is strong. I move down to the foot of the bed and unfold the yellow tarp to visualize the rest of his body. It takes me about a second to process the fact that his entire right leg looks like fresh ground hamburger. In another second my mind realizes that this man is in big trouble. His vitals are stable for the moment, and he is talking, but he won’t be for much longer. We need to MOVE.
Upgrade trauma yellow to trauma red now! The trauma surgeon arrives and starts shouting orders at about the same time my brain kicks into high gear. We have to stop the bleeding coming from his mangled leg, get a tourniquet around his thigh, start giving him a rapid blood transfusion, send labs, shoot x-rays, cut the rest of his clothes off, make sure we aren’t missing any other major injuries, get the OR on the phone and prepare to take the patient to surgery. And this all needs to happen 5 minutes ago.
I start delegating staff to get the rapid transfuser, pull uncrossmatched blood from the refrigerator, call the blood bank to send the red box (an ice chest containing extra blood products), get the thigh cuff and the tourniquet machine from the supply room. There is a flurry of activity. The ICU nurse arrives at the the same time as the rapid transfuser and the the red box. We get to work starting blood transfusions just as the patient’s blood pressure starts dropping.
This man is critical. We are working as fast as we can and praying that he can hold on. We followed him all the way through surgery, pumping blood into him as quickly as we could. I have never given that much blood to a patient, EVER.
He lost his right leg. He made it through surgery with only about a quarter of his upper leg left. His vital signs were once again stable by the time we got to the ICU. He has been intubated for surgery and, minus a leg, seemed to be doing well. I finally allowed myself to let out the big deep breath I seemed to have been holding since he arrived in the ER. We literally just saved a life. He would have a long road of recovery ahead of him and there were still so many things that could go wrong as a secondary reaction to all that his body has been through. But, for now, he was stable.
I will never forget that experience. It has been the most intense trauma I have ever been a part of. The ICU nurse kept in contact with the patient after discharge, and he would give me updates every so often. The man was an athlete. He was strong and healthy. He had been fitted for a prosthetic and was frequenting the gym.
A year after his accident, he came in for a visit. I happened to be at work that day. To see him that day was indescribable. He looked at each of us with such genuine appreciation that it literally gave me goosebumps. I was blown away by how healthy he looked. I was in awe at how strong his mindset was to have overcome such a devastating trauma only to be determined to bounce back. We saved his life. He honored all of our hard work by overcoming his disability and continuing to achieve incredible physical goals. He is an inspiration. He is that ONE patient that makes me so proud of what I do.