I walked into the hospital about 15mins before the start of my 24-hour shift. My on-call starts at 8am. As I walked from the gate to the Emergency Room (ER) to pick up the changing room keys, I contemplated whether I should have my coffee before or after the handover meeting. I hadn't decided before I opened the door to the ER. When I pushed the door open, I was greeted with the noises from oxygen concentrators, the sighs of doctors giving chest compressions, footsteps from nurses running around to administer medications and IV fluids.
A 9-year-old receiving CPR.
A middle-aged man lying on the floor breathless and motionless.
Another child with a head injury.
Plus, 32 more patients from a mass casualty incident in the neighbourhood.
For a second, I couldn't move from the door. My only problem this morning was making a decision about my morning coffee- not all of this. But this is a typical day in the ER- very unpredictable. There are no rules as to who walks into the ER, so every day is different. Some days are oddly quiet, while others are very fast-paced. I snapped back in, rushed to change into my scrubs, put PPEs on, and hopped right in to help.
I went outside to the triage bay to do the primary survey for the patients. I was doing 'ABCDEs' like nursery rhymes on repeat. Is their airway clear? Can they breathe? Are they in shock? Are their vitals stable? Are they alert? Are they bleeding? Do they have any major injuries? On days like this, the triage bay comes with an adrenaline surge. You have to be sure you're not missing any critical patient. You have to be quick but efficient. Within 15mins, I was covered in sweat. The colour of my scrubs had changed from light blue to a shade of cornflower. Decisions had to be made and fast (think seconds and a couple of minutes tops):
Where do I start?
Who goes in first?
Who needs x-rays?
Who is a possible admission?
Who needs a referral to another hospital?
Who needs surgery?
Today was a reminder that surgery (and medicine in general) is a team sport. We had an amazing team of doctors, nurses, x-ray and lab technicians, and cleaners who made sure every patient that entered that ER got the best possible care we could give.
Now the ER is totally silent. The floors have been cleaned, our scrubs changed, all patients are settled, the adrenaline rush over, and everyone is winding down. I keep thinking of all the multitude of emotions I have experienced in there today; for those we could save and those we couldn't. The thing about our job is that no matter how many people you help in one day, losing even one patient is really hard. But at the end of the day, satisfaction comes from knowing we did our jobs well. It was a privilege to have had the opportunity to help so many people in both big and small ways.