We were hanging out at one of the hospitals we sometimes transport to the other day and I was talking to one of the attending physicians. He’s a nice guy, worked in a number of places, and is very experienced. The talk turned to trauma and then shootings in particular.
Which is when he slipped in the sentence I quoted in the post title. The truth is that although new paramedics (and some that aren’t so new) get excited about shootings and trauma in general, they aren’t very challenging calls the majority of the time. It’s mostly ABCs, maintain the airway, monitor breathing, control the bleeding, drive to the hospital. Start an IV in most cases, just because. Fluid resuscitation is pretty much passe, MAST trousers are so 1980s, and more and more we’re being told that intubation kills trauma patients who might otherwise survive.
In other words, trauma is almost always a BLS call.
Still, it’s exciting stuff at first, but after a while the cachet wears off and they are messy and tedious. Or is it tedious and messy? Either way.
Until such time as science comes up with a magic elixir that can repair damaged tissue and a workable synthetic blood that carriers oxygen, paramedics will waste a lot of time transporting patients that can for the most part be handled by well trained and experienced EMTs.
It’s much the same for the doctor I was talking with. Seriously injured patients need to go to the Operating Room right away. Not so seriously injured patients go to CT or MRI, or get an ultrasound to see if they need to go to the OR. Even less seriously injured patients get treated for their injuries and admitted or discharged. Once the determination is made which category the patient falls into, the attending physician’s job is pretty much over. It’s even more so at big time trauma centers. A flock of surgeons descends on the patient and the Emergency Department physicians take a back seat. Interns do the interesting (messy) procedures because that’s how they learn to do them. By doing them.
So, you can see why my doctor friend doesn’t get excited any more when he hears that a shooting patient is coming in to the ED.
Or why I don’t get excited any more when I’m dispatched to one. Frankly, if I never see another person who has been shot I’ll be happy.