Trauma Surgery: Day 16

6a-5p today. Another busy day in the trauma life! The head of surgery was our attending for today, so we got another good lecture from his after our rounds. He is a definite asset to the medical school; he values education and medical students very much, and always makes me feel like I am really a part of the physician-team. We talked about Acute Pancreatitis, which is the condition that one of our patient's is suffering from. He is doing better, remarkably. Hopefully his labs continue to improve and he will come out on top of this. When he came into the SICU yesterday, the mortality was something like 30%...today I calculated it to be around 5%. As long as his condition continues to improve, he will be able to go home. The pancreas is probably non-functional, though, so he will be on strict insulin and pancreatic enzyme replacement therapy for the rest of his life. Many other complications can occur, such as malnutrition, GI obstruction, and transverse colon ischemia. It is a really serious illness.

The motorcycle trauma I spoke of yesterday is being excessively monitored for any changes in the condition. I am becoming more competent in reading radiologic studies, but there is a long way for me to go before I feel comfortable. I'm getting the hang of reading chest x-rays. The CT of this patient's head and neck is truly impressive. With the technological advances in imaging, we are now able to take the 2-D images from the CT scan and, using a clever software program, we can obtain a 3-D image that we can manipulate in many ways, like moving it in any direction, visualizing blood vessels, bones, tissue, skin, air, blood, and many others. It is really cool to be able to see things from so many different perspectives, it makes it easier to catch all of the little problems going on in a really injured patient.

Here are the CT images of the head from this frontal bone fracture. The brain was actually visualized through the bi-frontal bone fracture upon physical examination...

If there is any lesson to be learned here, please! please! if you're going to ride a motorcycle or dirtbike or four-wheeler or ATV, please! please! wear a helmet!!!!