Last night...

Wow.  Saw the worst, nastiest thing in a good while since I've been a nurse, and I've seen some nasty crap.  Had a girl come in from an accident with a HUGE laceration down the front of her face (down to the skull) and several other similar breaks in the skin.  The laceration ran from her forehead to her lower jaw, too.   However, what took the frickin cake was her arm...  OMG!  It literally looked as if it had been put through a wood chipper! 

Picture this:  At about the elbow, the girl's arm begins to peel away the skin and reveal the muscles/tendons beneath it.  You get past the elbow and see meat just flopping everywhere with bone fragments pushing up and out of that pile of meat.  All of the little bones in her wrist were clearly visible and becoming separated from each other (those that hadn't shattered anyway.)  Some few blood vessels were still hanging on (I don't know how) so the hand hadn't turned color yet from lack of blood/O2.  There was a thick band tied around her upper arm, but it was still oozing an alarming amount of blood.  Add to this the fact that dirt and leaves were swirled into the meaty mass, and you've got one badass wounded girl.

We elevated the "arm" (if it could even still be considered such) and wrapped the most gruesome parts in gauze and heavy absorbing pads.  Then we rolled to do a CT of her head/neck/chest/abdomen/pelvis.  More broken bones inside, but no internal bleeding in her chest/abd/pelvis.  She did have a slow bleeder in her skull, though.  Called the trauma team to confirm that the OR was gonna be ready soon, and brought her back down to her room. 

And then her mother got there...  I tell you, one of the most horrible things you'll ever hear is the wail of a mother whose child is as bad off as this girl was.  The girl had, apparently, been drinking and decided to drive home, which then resulted in her wreck.  Wonderful.  Actually, it was probably better for her that she was drunk b/c it at least dulled the pain she must've had going on.  Her mother ran to her side and just clutched at her and said her name over and over.  My coworker and I consoled her and updated her on all we knew, and what we were probably going to end up doing (give blood, go to suregery, etc.)  And then the Dr came in...

I haven't worked at this particular facility for very long, but from what I've seen, the Drs here are very good at what they do and very easy to work with.  However, I found out that this was not the case with this particular one.  Upon entering the room, he introduced himself, and then he jumped right to "Her arm is just nasty and awful, so we're gonna get it taken off."  No slow buildup or buffering, just threw it out there.  The mother screamed (of course) and begged the Dr to find something that could be done.  His only reply was " Well, you really should just be glad she's still breathing b/c her arm is just awful.  Do you want me to show it to you?"  OMG?!  I thought "He must be nuts!"  I've seen blood and guts a lot as a nurse, and even I was shaken when I had seen this girl's arm.  No mother should EVER have to see something like that!  Thank God she refused, though.  And with that, he turned on his heel and left the room, which was probably the best thing he did.  She eventually went out to try to notify her husband, who is in Iraq, in some way.  Then the girl's brother and sister arrived.  The sister collapsed, but the brother wanted to see the injury.  He was very persistent about it, even after I described it to him.  So I eventually uncovered a small portion of the arm.  He was pale and stone-faced after, but he thanked me all the same, saying that he needed to see it to make it real. 

We ended up giving almost 2 liters worth of blood to her before shipping her off to surgery.  Poor thing, she had woken up one time and began thrashing about trying to fight us.  She even thrashed that arm (ugh) before we got her sedated enough to be safe again.  The whole time I tried to keep as much of her covered as possible in order to save the mother from even more horror. 

What a night.  We worked on her for 5 hrs before she went to surgery.  That's some tough crap to do when you've got grieving family members around.  It taxes you emotionally.  When I got home, I fell in bed, literally fell and slept like the dead for 11 hrs.  I don't regret it one bit though.  If feeling beaten up is what it takes to help save a girl's life, then so be it.