PCMS_Philadelphia_Medicine_Summer2017 - 28

p h i l a m e d s o c  .org

FEATURE

Trauma Is As Trauma Does:

Healing Victims
By: Joel Fein, MD, MPH

It had been a routine night in the emergency
department at The Children's Hospital
of Philadelphia. I was winding down
an evening shift, finishing up my
charts so I could sign out quickly
at midnight and head home. Then
at 11:45pm the HASTE system
reported that in 10 minutes EMTs
would deliver a 14-year-old boy as
a trauma alert. The initial report
indicated that he was knocked
unconscious during an assault.
When the teen arrived, we were ready
for him. The trauma room lit up with docs,
nurses, surgeons, and medical students.
It was clear from the start that there
was something very odd about this kid's
condition. First and foremost, he didn't really
appear to be unconscious. He was staring at
the ceiling while maintaining his tone. All vitals
were fine, except for a slightly high heart rate.
Our airway person asked him his name, but the
teen just continued to stare. He flinched and
squinted when an IV was put in his left arm, but
did not stop staring.
The trauma surgeon asked us to prepare for a
CT scan for this unresponsive patient. That's when I
urged the team to slow down for a minute. The boy's
mom had just arrived. I asked her to go to the head of the
bed with the social worker and talk to her son. When she started
speaking to him, he began to cry. Then he told his mom that the
fight wasn't his fault. I asked him his name, and he said "Bennie"
in a loud voice.
28

Philadelphia Medicine : Summer 2017



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