Email from a trauma surgeon? Can you come to my ER and run a trauma team training session at 6:30 am for my residents and trauma team?

WISER response? No problem, tell us what you want to do.

The patient is a 24 y/o male, multiple gunshot wounds to the neck and chest. The patient will require a chest tube, a tracheostomy, and a femoral line. Off we go at 5:30 am to set up, and get ready? SimMan on the bed with gunshot wounds to the chest and neck. About an hour prep for this one? The neck has an exit wound.  Extra blood packs in the neck so he bleeds a little more than normal when they do the surgical trach. Chest tube module inserted.. Central line man off to the side, ready for action when needed. Tru Monitor running our physiology? I?m controlling the Tru Monitor, my coworker is controlling the simulator.

Off we go!  Trauma pagers activated, and in comes the trauma team. Gowns, gloves?

?Who has the airway??

?Someone get me a set of vital signs!?

Controlled chaos begins. Prior to the event, we found some great x-rays, CT scans, etc. in the simulator software and the Tru Monitor software.

Oxygen saturation is falling.

“His O2 sat is falling and HR is climbing!” yells the RT.

One of the resident?s yells, “Let?s get him intubated!” while another yells “I need a chest tube tray, I have no sounds on the left side. Get an x-ray to confirm.”

We push the x-ray to the patient monitor. “He has a left pneumo, someone get me the chest tube tray.” 

“I cannot intubate him, we need to trach him!”, yells the resident managing his airway. “Get me the cric kit and be ready with the tube and BVM.”

Once the cric was performed, the patient was stabilized, but still needed a central line placed. A femoral line was needed so the team transferred their focus to our femoral line trainers.

After the session was over, we started to clean up the room, and the simulator. He was through a lot this morning and it showed.

Forty-five minutes to clean the room, get everything packed up and head back to WISER.  A twenty-minute ride back to WISER… that was the easy part!  Now time to find out what we need to do to get everything back to normal.  Take off the head, clean the airway, replace the chest skin, replace the pneumothorax module, let him dry, back together and ready for the next class.