No Vacancy?

The Prologue

The other day we received several calls (five, actually) from various sources warning us that a patient was coming in by private vehicle with a HUGE laceration!

Now, we all know that what is and is not a HUGE laceration is a matter of perspective. Nicks, scratches, and scraps all can be HUGE lacerations to untrained or frightened eyes. It depresses me when I triage a patient with a HUGE laceration and it fails to impress me as HUGE or even as serious at all, and the patient becomes offended by my professional opinion or my casual demeanor.

People like drama in their trauma. I prefer realism.

The Real Story

Apparently, however, this patient and his buddy had presented to a local clinic in a small town seeking help with his injury. They found it closed and so called EMS. The first call we received was from Dispatch, telling us that they had dispatched an ambulance to the clinic to rendezvous with a patient who had a HUGE laceration.

But the ambulance took too long, so the patient and his buddy began driving to our facility at a high rate of speed. The second call we received was from the EMT on the ambulance who reported that the patient must have a HUGE laceration because he couldn't wait for EMS.

Tearing down the highway, the patient passed another EMT who called to tell us that the patient must have a HUGE laceration, because they were going so fast. A local paramedic in our town called to inquire whether or not we were listening to the radio traffic about the patient with the HUGE laceration coming in?

The last call came from our own admitting department. They wanted us to know they had received several calls about a patient coming in with a HUGE laceration.

Okay. It's nice to have a little warning. We prepped a room for a laceration repair, assuming that if everyone was correct, we were probably dealing with a serious venous injury are perhaps even an arterial bleed. Circulatory compromise to an extremity can mean the loss of it. Never a fun thing.

But what did everyone think? That unless we were forewarned, we'd have shut down the ER, turned off the lights, put up the No Vacancy sign, and gone home? Why so many warnings about a situation we face often and get paid to be prepared for ALL the time?

Epilogue

The patient arrived with a 3 x 1 centimeter laceration to his medial distal thigh. It was barely bleeding and there was no vascular compromise. He had hurt himself with a hand held grinder.

I've seen better lacerations. Even some HUGE ones.