This has been my favorite rotation so far. I enjoyed the variety in work, the complexity of the injuries and the story behind each patient. The two weeks flew by! The Shock Trauma Center is part of the University of Maryland Medical Center but is technically a free-standing hospital despite the connection in hallways; it is the primary trauma care facility for Maryland and is a level one trauma center so we were exposed to the most severely injured and sickest patients from the state. This trauma center is also well-known for being the first in the world to treat shock. We spent our weeks working with gunshot wounds, stabbings, traumatic brain injuries, motor vehicle crashes, motorcycle crashes, multiple types of brain bleeds, struck pedestrians, falls, and necrotizing fasciitis (part of the soft tissue segment of the trauma department). We then had to deal with the situations that come with these injuries such as colostomies, paralysis, chronic intubation/trach, long-term feeding tube access, long-term parenteral nutrition, uncontrolled blood glucose values, altered mental status, sedation, lean body mass breakdown, amputations and more. Some stories from the week:
- One of the patients was brought in after a drive-by shooting, but happened to have a warrant out for their arrest so they became a patient and a prisoner in one day. When the family came for a visit and got turned away by the police officer standing guard, a verbal fight ensued where one of the relatives almost got arrested for refusing to obey the officer.
- I had multiple patients die during this rotation but somehow I had more exposure to the families this time so it was more difficult, especially since most of the patients had been healthy prior to their traumatic injury and their death occurred at a completely unexpected time.
- We got to work with quite a few "interesting" patients where mental status declines led to some odd behaviors involving nudity, yelling, and cussing. One patient that we discussed with the med team was in with suicidal and homicidal tendencies. The homicidal tendencies were directed at medical professionals - so glad that I didn't work with them.
- We frequently had patients who were part of the evening news the prior night.
Some experiences:
- We got to tour the Trauma Resuscitation Unit which is the emergency department of the trauma hospital. We saw a surgery being performed through some doors but couldn't really see anything in detail.
- We also toured the hyperbaric oxygen (HBO) chamber where patients with necrotizing fasciitis and other serious wounds go to help their wounds heal through concentrated oxygen to help increase blood oxygen content.
- The hospital has a helipad where 3 helicopters can land to bring in patients and we toured that area as well. It was common to hear helicopters landing throughout the day so long as weather allowed. The day we toured the weather was rainy so no helicopters were on the landing area. It's a good thing the internet has photos of everything for me to use!
Up Next: Spring Break, 1 Week then Pediatrics, 3 Weeks
