Trauma

Once upon a time during the good old days of being attached to ITU, I came across a scene in the A&E where a rather mangled individual was brought into the resuscitation room. And this guy was seriously mangled; limbs were at odd angles and he quite literally had bits of brains on the floor. After the initial ‘Fucking hell…’ the next thought on my mind was ‘What the hell do I do next?’. As it happened, I was only there to observe, so I just stood back and in one of the rarer moments of being fantastically impressed with the A&E staff, watched the team swing into action.

I went away from the experience with a promise to myself that I will learn more about trauma situations and the exact manner in which appropriate management should be put in place. That, in turn, led me to enrol myself onto an ATLS course.

The ATLS (Advanced Trauma Life Support) is a training programmed for the management of acute trauma that was developed by an American orthopaedic surgeon by the name of Mr Styner who had crashed his light plane in a field back in the 1970s. His wife was killed instantly and his children suffered critical injuries which he had to sort out himself on the field. However, things didn’t get much better when they arrived into the hospital, and he had to get himself out of the bed and organise an adequate and appropriate response to the injuries that his children received.

Swearing revenge (ok, he didn’t actually), he set out to improve things and it is from his perseverance that a standard system for the management of trauma was established and has subsequently been adopted worldwide.

The nature of the course attracts applicants who’re keen on surgery, A&E and anaesthetics so many of the instructors were surprised to see an F2 in O&G with aspirations of being a physician in the course. And I think that that is one of the downsides of the current mismanagement of medical training in the UK – you don’t get the opportunity to spend a little time in areas of interest or spend attachments to gain new skills if it is not deemed necessary for the career of your choice. If you wanna be an ENT surgeon, don’t bother learning about ECGs. And so on and so forth.

Personally, I think all doctors should at the very least :

1. know the basics of medicine and surgery
2. what to do if someone falls down in front of you
3. what to do if someone suffered a traumatic injury e.g. hit by a car or whacked on the face with a baseball bat
4. recognising if a pregnant lady needs medical attention
5. likewise with a kid
6. have decent handwriting and other nitty-gritty things that I won’t get into.

So having been told by various people that spending £500 on a course that will have no relevance whatsoever in General Medicine application is a waste of time, I went ahead and had a rather enjoyable 3 days of training.

The course was well-organised, with friendly but stern instructors who didn’t suffer fools. And although it was mentally and physically draining, time just flew by ‘cause various new bits of information was seeping into our brains (I've learnt more in the past 3 days than in the past 3 weeks of O&G, that's for sure!) and we had lots of skills and scenario stations including bits where we were able to practice our surgical airway skills on little dead sheep.

MBek.

I felt a little nervous but didn’t feel as stressed or nervous as my subconscious probably did - I somehow managed to develop a zit and a mouth ulcer over the past couple of days. Thankfully, the tests didn’t go pear-shaped and I performed well enough that I would’ve been invited to be an instructor if it wasn’t for the fact that I was too young (all instructors are at least of specialist registrar level). And this translates to a middle-finger salute to the folks that kept on harping about how a ‘medicky-person’ won’t be able to change his mindset in a trauma setting.

Unfortunately, this medicky-person has to now study for the MRCP Part 1 exam in 16 days which he has ‘cleverly’ signed up for. I am not too fussed though – I’ll either prove that hardcore mugging of 2 weeks’ duration is sufficient for the exam or I’ll just resit it a little later.

I quite look forward to the latter bit of spring and then summer actually, as I’ll probably spend a bit of time not studying and I should be able to indulge myself in a few novels (yes, I’m also waiting for the last Potter book), movies (starting with Spiderman 3 next weekend. And there’s also Shrek, Pirates, Transformers, Ocean’s 13, Fantastic Four, The Simpsons & The Bourne Ultimatum to look forward to) and maybe even a short holiday, with Prague being on top of the list.

More importantly, I should be able to spend more time just chilling out with my friends (which I did to great satisfaction last weekend) and with Sweetie. But all that’s for later. For the moment, it’s the beginning of night shift and hoping that not too many babies get delivered over the next week!