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A head injury day...

It was barely 8 but the day had already begun. The young man on the trolley was awaiting theater. He had been the front seat passenger in a car that had crashed onto a wall. His friend, drunk, was in police custody. They had been drinking at a party until early hours. The injured boy did not appear that drunk. He was smart and was inspecting his surroundings with a dull interest. Helani approached him with a friendly smile. She spoke to him merely to start a conversation as she flipped through his notes. He was an engineering student. He had tried to warn his friend before the accident but it was too late. His friend was a good guy. Yes, his arm was painful- it is broken, he had been told. And the hip which was dislocated hurt too. Yes, he had been given some injections for pain, thank you. Helani was glad that she touched his forearm for a pulse- there was none. She quickly called the nurse to release the splint, pulled the hand and checked again. The pulse returned. She checked
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Trapped

The morning started alright. The staff nurse was checking the equipment with an assistant. The anaesthetist, Roy had just introduced himself to Helani. He took a brief 'history' from Helani, and then went on talking about his life, his marriage, his divorce, his interests... This was nothing new to Helani- she frequently found people opening upto her. Perhaps she was a good listener. Perhaps her introverted personality invited the other party to talk more. Whatever. The peaceful environment was disturbed with sudden opening of the R room. A trolley was wheeled in fast. The well-built young man on the trolley was bleeding; his shirt was soaked. At a glance Helani saw that he was not breathing. She jumped onto him and started compressions, shouting instructions to others: bag, connect to monitor, cannula, cut open this shirt... Roy was managing the airway, and a nurse took over the compressions. They were enthusiastic student nurses and Helani was glad. The man was in asysto
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Windy December

Helani walked into the resuscitation room, or the R room, as it is known here. When this trauma center was designed a few decades ago, they had decided a 5m x 5m square is adequate for the purpose of resuscitation. It had not changed much since then thanks to the resistance of the nursing staff; with much trying by enthusiastic doctors, its wall cupboards were now labeled to indicate what was in there; there was a trolley like the ones you see at supermarkets, which served as the crash cart. The room was air conditioned. It had 3 doors, one of which was permanently blocked by cupboards. One door opened to the triage area; staff used the other entrance, which opened to the general treatment bays. The anaesthetists and the emergency physicians chose to stay inside the R room while the rest of the staff members arrived only at the triage bell that indicated the arrival of a category 1 or 2 patient. There were 3 comfortable chairs next to a table fixed to the wall. The X ray viewers were
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