Today was my first pre-call shift. The pre-call schedule is relatively chill. We start the morning as usual; getting numbers, pre-rounding, rounding, pass-on. Then our team goes to do the surgeries that are scheduled for the ACS teams, split into either trauma or non-trauma, with note-writing and orders and other various tasks sprinkled through.
On the non-trauma side there was an appendectomy. On the trauma side, we had a pretty gnarly leg wound debridement. I remember seeing the patient in the ED when we were on call just 3 days ago. She came in with super severe leg pain with imaging and labs concerning for a bad infection. I guess they debrided it the text day, and today she was scheduled for us to clean it out again. She had 3 big openings (made by the surgeons) going down the lateral aspect of her right thigh, each at least 6 inches apart, and 1 opening on the upper medial part of her thigh. Each one of these openings communicated with each other.
During the surgery I was able to feel the tense fascia that runs down the lateral leg (aka the fasciae latae) and was able to touch my finger coming in from one of the other openings. We had to clean out any developing clots from old blood that was collecting in there and also look for pockets of pus/ infection.
This poor women, must have been suffering for a long time for it to have gotten as bad as it was before coming in, and the recovery is not going to be easy, with her likely needing to return to the OR before going home.
–
–
TTITF:
(1) You
(2) High-quality sunscreen
(3) The learning opportunities I get every day in the hospital and the residents, fellows, and attending who go out of their way to teach me something even if it means taking a little more time to do a task.
nANIMOv 