This trauma week was probably one of the least interesting topics to me, yet still, I think I’ll remember this one the most. Starting on Monday it was revealed that the incident was a chemical weapon going off at a concert. The five senior biomed students were playing as the victims and the manakin was our seriously injured friend. After the chemical weapon exploded we all began to scream and await the fire department's rescue. Once they arrived we began to move away from the scene of the incident to an area between two fire trucks. Now the purpose of us seniors pretending to be injured was to get to walk through two fire trucks blasting water, and we were told to prepare to get “a little wet.” We quickly realized that a little wet and fire trucks are probably antonyms. Thanks to the fire chief we were no longer required to walk through the detox zone while the water was blasting because it was too cold, so we just triaged ourselves instead. We did still get to see the two people in hazmat or “among us” costumes rescue the manakin, and they dragged it through the whole detox zone and then into the ambulance. Paramedics then begin to show us what they would do in the situation: It’s quickly found out it was probably a chlorine explosion, they immediately start providing breaths by bagging the patient and CPR, eventually, they put an entire CPR machine on the manakin. They then start breaking down all the different medicines held in just one ambulance and all they’re allowed to do. The next station is the chemical emergency truck where they show us the multitude of equipment. On the inside there are computers to monitor the people in the hazmat suits, one that gives the specifics about the weather, and on top is something that can spray water to disperse toxic clouds. Lastly was the fire truck which had 500 gallons of water in it by itself. They showed us all the different things hidden in the walls so they can deal with any situation, they also mentioned that that specific fire truck has jurisdiction that can go all the way down to Flordia. We were also shown the process of cleaning off a hazmat suit, but they said they’d usually just cut the responders out of the suit and then throw them away. After nearly two hours in the cold, we went inside so the fire chief could lecture us about some specifics. To me the most important part was setting up a clean and a dirty zone to try and control and detox as many people as possible as fast as possible.
Tuesday we went through many different stations that explain what happens in a situation of mass chemical exposure. My part was to scream I can’t breathe and my chest burns, so I was the most important and needed to be detoxed first. Our detox area was an emergency inflatable that almost looked like a bouncy house. The patient is supposed to walk through and attempt to clean themselves with assistance from emergency responders. Next, we learned about respiratory issues and how they are treated in the hospital after a chemical incident. The speaker showed us an endoscopy which is inserting a long flexible tube down the patient's throat, a tiny camera is placed on the end to see the current condition of the throat. The most interesting part of Tuesday was the practitioner who put, what seemed to be, an eyeball IV into his own eye. The actual term for this device is a lacrimal apparatus. While the picture shown may look disturbing it actually didn’t hurt him at all and he went on to teach us about the different types of chemical burns. He also went on to tell us a sentiment that was repeated several times during the week which is that there are actually six degrees of burns. It also came as a surprise to me when we learned that bases do more damage to the skin than acids to the skin. This is because the skin absorbs things of a more basic pH while acids sit on the top.
Wednesday was a little bit of a shocker as there was no physical speaker instead Peter Lutz recorded a video to teach us about different types of airway injuries. An upper airway injury is most likely a chemical injury or heat injury, while lower airway injuries are only chemical injuries. Every one in four people dies if burns spread to 50 percent of the body. A possible treatment for these injuries is a tracheostomy. A tracheostomy is a procedure to help oxygen reach the windpipe by creating an opening from outside the neck. This can last anywhere from 10 to 14 days. Medications such as bronchodilators, heparin, and N-acetyl-cysteine can work to provide a quicker method of healing to a damaged airway. These injuries are very dangerous, but the most dangerous part of them is the swelling that occurs.
Unfortunately, Thursday was my last day in trauma week, but it was a good ending with probably one of the chilliest speakers we’ve ever experienced in Biomed. She is a nurse practitioner who gets to actually perform surgery in South Alabama’s burn unit. Unsurprisingly 68 percent of burn victims are men and the most common type of burns are fire and scalding and 73 percent of injuries take place at home. The average length of a stay in the burn unit is eight days. We got another look at 4th-degree or full-thickness burns, these burns reach the muscle and bone and possibly require amputation. The appearance of these burns is constricted as when burned the skin tightens, this can block airways as the chest cannot fully rise to allow air in. This is where we see how the burn unit shaves people's skin off to get rid of the dead cells and also realise the constricted skin. We practiced figuring out what percentage of the body is burned on an inflatable manakin. One adult hand is accounted to be around five percent of the body, after identifying the percentage the manakin was burned we then did the math to find out how much liquid the manakin needed and this was 105 liters.
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