A terrific day

It was the smell of disaster and accidents when the conditional MCO (movement control order) is relaxed, allowing people to travel inter-state. Some may argue that relaxing it may cause a sharp rise in travelling rate and hence, accident rate. However, just like the human body who will undergo illness and injury, people too, may not have good luck all the time.

Lue and I were the only MO (medical officer) working in red zone yesterday. I decided to pen it down as the injury is so devastating and the loss is beyond words. 

Being the junior MO, I was carefully guided by Lue. Thankfully we have a group of diligent team in the zone. We received an ambulance call for an intra-abdominal injury, were being told that few others had died on the scene and they manage to extract only this patient. 

Initial assessment had been done, we thought that there is only injury on the abdomen since it's tender and guarded. However, the Chest X-ray decided to add horror to our day. It was pneumonediastinum (thanks to Lue who is able to spot it) and pneumothorax! 

Chest tube were inserted immediately, albeit we encounter slight difficulty initially, but thankfully Janice came and helped. Ventilator setting has to be low in view of the pneumomediastinum which may be caused by tracheobronchial injury. 

Surgical team came and assess the patient. They requested for CT Abdomen and Pelvis. However, our radiology team noted the extensive subcutaneous emphysema and decided to do a CT Thorax too. True enough, all the other injury you could possible think of is present.

This is just one of the patient for my shift. Not mentioning the other accident patient we attended with Le Fort II fracture (involving inferior orbital wall and maxilla); the one DKA (diabetic ketoacidosis) patient whom we can't find the source of infection; the anterior chest wound patient at the beginning of our shift which pushed to OT straight; the stranded patient in our zone who developed hypotension; the vagabond whom we don't know the cause of his altered mental status; the elderly patient from Hospital Bahagia who had persistent hypoglycemia; and many others.

As a junior MO, I feel the patient does not wait for you. You just have to progress, and improve. Patient will come with the worst possible injury without asking who is the most senior in the Emergency Department. 

In order to strive, sometimes we have to make tough choices although easier ones are available.