Coordinated Chaos

This is the main receiving trauma bay in the ED (we have 8 of these, although not all this size).  When we get a trauma call (the  so called Catagory A patient), the teams assemble, not unlike any major trauma center in the world.  From left to right:  Team leader (ER physician), runner (for blood and supplies), Radiology tech, Level 1 blood infuser nurse, Radiologist, Nurse leader (with back turned), ER resident and primary surveyer (leaning over bed), nurse (male with back turned to picture), Anesthesiologist and tech (facing toward picture and head down), Medication nurse (standing over yellow box), the three to the far right are two other Level 1 infuser nurses (can infuse a unit of blood or plasma in 30 seconds) and the man with the red cross is the transporter of patients.  Not seen are the three others just beyond the picture which is the Trauma Nurse coordinator who writes all vital information down as it is shouted to them, the Aeromed evac team to start getting ready to fly the patient home and the patient tracker who can contact commands and families to notify them.  

There is always a din of noise with side conversations, until the door swings open and the helocopter team leader comes in to report the patient while the ambulance teams gets them ready for treatment - then it goes silent and you could hear a pin drop.

Again, this isn't too different from any trauma center in the US.  What is different is about ten feet behind the Team Leader where you will find two of each of the Attending level physicians - Trauma Surgeons, Orthopedics, Vascular Surgeon, Plastic Surgeon, Anesthesiologists and the OR nurses - See Below.

Attendings waiting like coiled springs to jump into action.  There is the dreaded yellow line on the floor where we stand behind until called by the team leader to do our part.  In all its there are about 35 people in the trauma bay.

Within about 15 minutes we have stabilized, intubated and resuscitated the patient and they are now in the CT scanner.  Here the attendings are jockeying for position to see what has to be done.

CT scan is done and patient is in the OR.  This case needs Ortho and Trauma surgery - he gets prepped (and a quick bath to get all the dirt and mud off) and away we go.  This happens on average of 2-10 times a day.  (I'm at the head of the bed facing with black and white scrub cap on).

All for now.