The Trauma Room

The trauma room

Almost every hospital has one or even several, interesting to many doctors but for patients a place you'd rather not go: the trauma room. How exactly do you get there? What happens to you in this room? And who all is involved in the care of a trauma patient?

*** BEEP BEEP BEEP ***. My pager's loud, shrill and mostly unmissable alarm goes off and on the screen the word "TRAUMA" appears in large letters . This means that down in the Emergency Room the trauma signal has been turned off and a seriously injured patient is on his way to the hospital. I know that along with me and the surgeons, I am doing fellowship in the trauma surgery department, colleagues from anesthesiology and radiology, among others, have also been called in and have to immediately put their other duties aside. They are all part of the trauma team and will also rush to the trauma room to receive the patient. Once there, the SEH nurse briefly explains the situation; "Male, 35 years old, fall from scaffolding with possible brain damage and multiple bone fractures. The Mobile Medical Team arrived at the scene by helicopter and assisted the ambulance. The response time is 5 minutes'. The plastic aprons and gloves are put on and stickers with name and function make it clear who has what task. The plan is reviewed for the second time when the ER nurse shouts "the patient is here!" and it is wheeled in by several paramedics and a helicopter doctor. It is busy in the trauma room, but we get started right away under the motto "treat first what kills first"....

The above outlines what happens before a patient enters the trauma room. However, that is only the beginning. Once the patient is on the table, he or she will be examined from head to toe according to the Advanced Trauma Life Support (ATLS) protocol. Each member of the trauma team has his or her own task in this process. The trauma surgeon is often in charge and provides an overview, the anesthesiologist is responsible for maintaining vital signs (breathing, blood pressure, heart rhythm), the neurologist checks for injuries to the spinal cord and brain, for example, and the radiologist takes care of the X-ray, ultrasound and/or CT images. A fixed system is used to check the patient in order to detect and treat the most life-threatening injuries first. Among other things, blood is taken and the patient receives an infusion for medication (e.g. pain relief) and fluids. In addition to physical examination, X-rays are taken to detect fractures, an ultrasound to detect blood or fluid, and sometimes a CT to see if there is injury elsewhere in the body. Depending on what is found, immediate action can be taken: if the patient has difficulty breathing, he or she will be intubated, if there is blood or fluid in the chest cavity, a drain will be inserted, bone fractures can be repaired, and if there is a lot of blood loss, a transfusion may be given. Only in very severe cases will the patient actually undergo surgery in the trauma room.

Only when the patient is stable (enough) and the main injury has been identified can he or she move from the trauma room to the operating room, for example. There, operations are performed to straighten broken bones, stop bleeding and sometimes even relieve pressure in the brain, among other things. Finally, the patient goes to Intensive Care to be monitored closely and treated further. This process takes longer for some patients than others and some patients unfortunately do not survive despite all efforts... However, the goal is ultimately the same for everyone: to send the patient back home as healthy as possible!

The trauma world is special. It puts you with both feet on the ground, shows you how vulnerable you are and that an accident can be in a small corner. Yet I continue to find it fascinating and exciting and beautiful to see everyone, both inside and outside the hospital, working together as best they can to save a human life.