So a Dude comes in. He's got a 2 cm puncture would just below his clavicle (collarbone). Happened an hour ago. Newbie triage nurse puts him in the Acute bed. O2 is fine, respirations are fine. Dude looks like he needs sutures. Newbie triage nurse gets jested for her choice of spots for Dude. The story comes out as ER doc happens to walk by and chats with Dude as me and partner start doing our vitals and full assessment. Turns out his girlfriend stabbed him with a pretty long knife. Suddenly...and I mean suddenly...Dude gets quiet. A quick blood pressure shows his pressure is 50...i.e. deadly - very very very bad (he just happened to have the cuff on and it went off). We lie down Dude and the left side of his chest is about double the size of his right. This also occurred very very suddenly. A Code Blue is called. Within minutes Dude has a chest tube that drains a bunch of blood - he had a tension hemothorax. The knife nicked a vessel and his lung causing it to collapse. The accumulation of blood pushed the lung over until it was compressing the heart. If he had shown up 5 minutes later he would have been dead.
Once he's stable, his heart is beating properly and lung is reinflating thanks to the chest tube Dude is sent over to CT to see what other weird and wonderful injuries might have occurred. There is myself, another nurse, two porters and the CT tech. I start thinking to myself and share my thoughts with the group. Why would a girlfriend stab her boyfriend? Not that I am condoning it of course, but what is the ONE reason you can think of? Sure enough when the police are talking to Dude the full story comes out and my suspicions are confirmed. Dude had a Dudette on the side. Tsk Tsk Tsk.
So people in Bloggerland...what does this little story teach us?
1. Never underestimate newbie triage nurse. She may look like she's 12 but she actually knows what she's doing.
2. Never forget how dangerous those penetrating wounds can be...what sort of damage they can cause even an hour later
3. Get rid of Dudette number one before you hook up with Dudette number two. If you don't, life may become a bit more complicated.
Sunday, November 14, 2010
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I just finally found my link to your blog (it's newbie triage nurse!!) and I love this post! That was my first shift on triage ever. The next patient if I remember correctly was a dizzy, tired older lady with a heart rate of 29. I got razed for that one too...since I was bringing in another patient that looked "okay"... she was dig toxic.
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