Yesterday was a pretty average day working in the ER. It was pretty busy but we were staying ahead of it and it wasn't bad. Until the call came over the radio. It was 5pm....3 men down, on a part of the highway that is closed and not meant for driving. 5 minutes later they came over the radio again, 3 criticals, all coding, all very sick. Other things were said like, "half of his skull is gone," "thrown 100 ft," "unconscious," "unresponsive," "young."
The charge nurse and I started to put together teams, pulling nurses from other parts of the hospital. We had 3 rooms ready, 3 teams ready, waiting. That's when I realized something....OH SHIT....I'm the only doctor. How can I possibly run 3 codes and take care of 3 critical patients in 3 different rooms at the same time? Oh shit, oh shit, oh shit, oh shit. To say I was scared is an understatement. Everyone is looking at me like I'm the one with all the answers. Oh shit.
In rolls the 1st ambulance with a young person (19 or so), blood everywhere, unconscious, cold, no pulse. So we start the code and get ready to intubate when in rolls the second ambulance with another young person (25) missing a large part of his skull, not breathing, no heartbeat, not responsive. I run to him and realize that there is not anything that can be done.....I call it and back to the other patient. Attempt to intubate with blood and puke and stuff EVERYWHERE. I look down and see blood and spinal fluid running out of his ear....oh SHIT. All the while we are doing CPR and giving drugs, trying to get a heartbeat, trying to get anything.
In rolls the last ambulance. This patient is alive, barely, but alive. I look up and see one of the local doctors who came in to help....thank God! Rush back to patient #2. There is no hope for him. Pronounce patient #2. Back to the one guy who might make it. Intubate, CPR, drugs...we have a pulse. He eventually made it to a trauma center via helicopter and is still in critical condition. I don't hold out a lot of hope that he will make it. It was awful. Not a good night, not for anyone.