Rollover Accident

Yesterday two women, about 50 years old, came into the ER. They had been injured in a rollover car accident.  Suddenly, during an already full clinic day with the hospital hallways already full of people, we had 2 trauma patients and all the family that came with them packed into the ER.  Handling even one trauma patient is difficult for the clinic nurse, who is already triaging, evaluating, and shuttling patients through the process to been seen by 1 of the 4 clinic doctors working that day.   Good thing it happened during the day when there were extra hands around to help out.
The first woman had a broken radius (forearm bone) and a pretty big gaping hole through her hand at the base of the middle finger.  She had crushed the base of that finger bone and severed several tendons in her 2nd and 3rd fingers.  It was obvious it would need to be repaired in the OR so I hooked her up to the monitor, gave her some good pain meds, and temporarily bandaged up her hand.  She went for surgery by the end of the day.

The hand surgery by Dr. McKenney and Rosanne

The second lady was complaining of shoulder pain.  Her x-ray showed a fracture of her upper arm bone near the shoulder (humeral neck) and she was actually moving on her own.  The patients here are tough as nails and rarely ask for or need pain meds.  Of course, I gave her some good pain meds too.  She also had a headache and vomited a few times in the ER and we don't have a CT scanner to check for head injuries so I decided to keep her overnight to make sure she was alright.
They both did well overnight, not even asking for pain meds and I sent them home today . . . with a few pain med pills . . . just in case they needed them.