Responding Empty-Handed but Full-Headed
It didn't take long to realize that the young man driving was distraught by the apologies he was spewing at the man who lay on the ground in pain and shock. To make things worse, the man's dog was only feet away showing no signs of life. With no traffic around, I made my way to the middle of the intersection as a first responder to assess the situation. Two patients: both alive, one clearly injured and the other in a state of hysteria. The police arrived shortly thereafter to control traffic, call for medics and calm the driver. My training took over and after a quick introduction to the injured man I began a rapid trauma assessment looking for injuries from head to toe. Once it was determined that there were no obvious life threats, I focused on those things that he could identify as bothersome. With no equipment to dress his wounds, I started taking a medical history to keep his mind off of the loss of his dog and to provide the medical crew when they arrived. It was sad to see the aftermath of an unintended event and I can only imagine how it will change their lives forever.
Moments such as this benefit from the "what if" game I have played so often. Never knowing when I will have to use my training keeps me in a constant state of preparedness. It's an awful thing when people become injured or ill, but knowing how to help in that time of need is a comforting feeling. A feeling that I would rather have than that of helplessness when it matters most. I will likely never hear from the individuals involved in this particular incident, but the satisfaction of being prepared was fulfilling enough to know that I am slowly learning that which I need to and understanding how to apply it in practical situations. It was another affirmation that my pursuit of emergency medicine is not in vain.
Question of the Week
All of the following are surgical emergencies EXCEPT:
A. A tense swollen foot that was run over by a car. There are no fractures but the patient is in severe pain and has pain with passive toe extension.
B. A tibia fracture with a small pinhole in the skin over the fracture site that drains blood containing fat droplets.
C. A knee dislocation with no fractures, but a cold pulseless foot.
D. A supracondylar humerus fracture in a ten-year-old with decreased sensation in the median nerve distribution.
E. A distal radius fracture in a five-year-old with obvious visual deformity and intra-articular displacement.
Answer & Explanation