Newsletters

POSTED: December 17th, 2021
POSTED IN: EM Pulse - The Official Newsletter of MOCEP, November/December 2021,

Written by: Katherine Stuart

As someone who wants to pursue a career in Emergency Medicine, I was excited to learn I would have the opportunity to spend time with the Trauma Surgery Department at St. Louis University Hospital during my surgery rotation. Before attending medical school, I spent eighteen months working as an Emergency Department scribe and as an Emergency Medical Technician, so I was very eager to return to the field of emergency medicine.  However, all of my prior ED and EMS experience was from a rural setting. The thought of working in a Level 1 Trauma Center ED was both exhilarating and intimidating.                                                

I came prepared on the first day on this service with a fresh pair of trauma shears and plenty of snacks. The first major trauma was a pedestrian vs. auto with massive extremity injuries, multiple rib fractures, and a pneumothorax. Standing with the team in the trauma bay wearing fresh gloves and a disposable gown before the patient arrived, I was surprised at how many people had responded to the trauma alert and how relaxed they all appeared to be. Having worked in EMS and the ED, I had a general picture of how a trauma activation would run but participating in the carefully choreographed routine was a truly rewarding experience. As we waited, one of the nurses was amused when he saw my shears already in my hand. When the patient arrived, the team burst into a flurry of activity. I did my best to keep up with the nurse on the other side of the patient as we raced to get the patient’s clothes cut off. Not surprisingly, he easily handled his side of the patient more quickly than I could.

Each patient was approached in a formulaic pattern: EMS hands off the patient, the team transfers the patient to ED stretcher, the staff removes all patient clothing while the ED resident assesses airway and breathing, and the trauma resident conducts a primary survey of the patient noting any injuries. Next radiology squeezes in for X-rays all while I, as the medical student, obtain what history I can extract from the patient. Then the patient is whisked off to CT, and the team proceeds with appropriate care.

By the end of the first week, I had seen more trauma than I had seen in my entire EMS and scribe career combined. I had been a part of the team that cared for a variety of patients with penetrating trauma, including several gunshot victims, motor vehicle accident patients, and even a patient who had been attacked with an axe. Every day brought new experiences and challenges providing me with a phenomenal learning experience.

Though my time in the OR was a great learning opportunity, I found myself continually volunteering to stay in the ED for the resuscitation/activation activities. Although the rotation was mentally, physically, and emotionally taxing, I must admit, the trauma surgery service has been my favorite rotation thus far in my medical education. My greatest takeaways from the experience were the model of excellent collaboration between the emergency department staff and the trauma surgery team and how a well-trained, multidisciplinary team can provide excellent care for patients with severe traumatic injuries. I am truly grateful to have had this unique opportunity. Though I know not every medical student has the privilege of rotating at a leveled trauma center, I would highly recommend all EM bound students consider rotating with a Trauma Surgery service.