Emergency Trauma Video: Sharen's Story

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Transcript

Helicopter Radio: Sharp, Medic 17...I have a trauma for you guys.

Radio Nurse: Go ahead, please.

Helicopter Radio: OK, 55-year-old female, weighing approximately...

Overhead Page: Trauma Team Alpha, Emergency Department.

Nicole, RN: 55-year-old female, fall from a horse, drug around the corral by the horse.

Dr. Bellezzo: She came to us with injuries that are potentially life threatening.

Nicole: The whole process of healing starts the minute they come into the trauma room. Right away, the best thing you can do is control their pain.

Sharen: (groans)

Nicole: You're flat on a board. You just took a helicopter here, and you're rushing into a trauma room and you've got eight or nine people grabbing at you, cutting your clothes off, covering you with blankets, putting in IVs.

Dr. Bellezzo: Call to the OR.

Nicole: We always right off the bat say, "This is the trauma team. We're here at Sharp Memorial Hospital. We're going to take care of you. This is what's gonna happen."

Dr. Bellezzo: I'm Dr. Bellezzo, hang on one second. I'm Dr. Bellezzo, Dr. Kill's gonna be with you in just a moment, OK?

EMT: ...was dragged around a corral, hit the cement posts all the way around, three times around. Husband reports that a helmet came off during the event. She has trauma to her left abdomen and left chest.

Dr. Kill: X-ray, come over here. Hon, what's your first name?

Sharen: Sharen.

Dr. Kill: Sharen, wiggle your toes for me, hon, squeeze my hand. Good.

How about your belly? Hey, Sharen...Sharen I want you to bend your legs, hon. How about this leg, bend this one. Why can't you bend it? It hurts?

Nicole: We're gonna get some stuff done, OK? I know, sweetie.

Sometimes just whispering to a patient, "This is what we're doing. I know you're in pain" is the most comforting thing. Holding their hand...

Cozetta, RN: That line's working great...it's working like a champ.

I hate to tell a patient, "You're gonna be OK" because sometimes things can completely turn around and it's hard to regain trust. That's a definite no-no.

Dr. Kill: We have no vital signs yet, guys?

Nurse: 93 over 52. Low blood pressure.

Dr. Bellezzo: She had a low blood pressure. She had a high heart rate, and in the setting of trauma, that can only mean blood loss from somewhere. So the next step is to figure out where that bleeding is and stop it.

Dr. Kill: Call the ultrasound tech and tell him to come now.

Cozetta: They're on their way.

Nicole: When you have a patient with abnormal vital signs that are consistent with bleeding yet there are no outward signs of bleeding, we use ultrasound at the bedside, to determine where the bleeding is coming from.

Dr. Bellezzo: We found that she had had a spleen injury.

Nurse: She's got fluid around her spleen.

Dr. Kill: Is the OR ready?

Nicole: They said come up whenever we need to come up.

Dr. Bellezzo: I have a minimal pulse up here.

As the ER docs, one of our specialties is managing the ability of the patient to breathe. That leaves the trauma surgeon the freedom to assess all the other patient's injuries.

Dr. Kill: She's got a left-sided superior/(inaudible) fracture, she's got a massive iliac wing fracture.

Dr. Bellezzo: You can lose a whole body's volume of blood in the pelvis.

There we go, back one, two, three.

Dr. Kill: OK, lock it down, lock it down.

Dr. Bellezzo: A pelvic binder is this contraption that goes around her pelvis and wraps it tight so that those pelvic fractures that are now open and bleeding get pulled together so that the bleeding will then stop.

Dr. Kill: Call the OR. Cover her up. We're going.

She's at level one.

Dr. Bellezzo: She's going to the operating room under the care of a trauma surgeon in a situation where she needs an operation that will save her life.

Dr. Kill: Go, go, go. Let's go, let's go, let's go.

Peter: She knows horses better than anybody I know. Twenty-five years ago we would go ride together, ride down the beach together. It was great. Great horsewoman.

The horse spooked, took off, and then he planted his front feet and Sharen went through the reins. So when she hit the ground, she was being dragged by the reins and the lead rope. The horse started to drag her and he dragged her around the arena, all the way around, probably three or four times. She had both hands like this to stop from being hung, from being strangled.

And every time I'd try to make it stop, the horse would dive around me. What he was doing was throwing her this way and this way, like at the end of a whip line. That's when she hit those concrete posts. It was a really bad sound. It was horrible. It was really horrible.

Dr. Kill: I need a clip-o-plier. Medium and large. We removed the spleen and she had a ruptured stomach. She had about a 6-by-4-inch blowout at the back of her stomach.

Nurse: We're still getting O negative.

Dr. Kill: We used a combination of suture and surgical stapler to close the hole in the stomach.

Give me a suture.

Dr. Kill: I paint a very realistic picture to families and give them the whole range of what can happen.

Peter: I don't remember his exact words but he communicated this is as serious as it gets. There was a chance that she could die.

Sharen: I knew inside there were major things hurt. I didn't see a way that this was gonna end except with dying; truly, I didn't.

Cozetta: I have to give you a hug. 

Nicole: You look absolutely wonderful.

Peter: You know what you should do for a living?

Cozetta: What's that?

Peter: What you're doing.

Colleen: Our work is very personal and that makes it emotional. We take these people home in our hearts. We take them home in our minds. We think about them when we go home.

Cozetta: It's a blessing. A miracle. I look and go, oh my God you look wonderful, because the last time I saw you it was pretty bad. And to see you now, up and walking...that's gonna make me cry.

Colleen: When patients come back to us, they don't realize the real gift is just seeing them. Everyone who does this job, loves it. The pride you feel in what you do, the feeling of accomplishment, returning people to their hopes and dreams…to their life.

Sharen: Come on...good boy. (laugh) It's been a while, that day I did everything wrong. I just skipped every one of my own rules. I went from A to Z. None of this is Harry's fault, the horse.

Peter: When she finally woke up, I had a feeling that it's gonna be okay. And you know what...she's alive. That's as perfect as you can get. She's alive.

Sharen: If you don't understand what life is about, you can sit by a horse — and you'll figure it out.