Last night I had to choose between going to happy hour with my Sunday school class at the (Methodists are awesome) or taking call overnight with Orthopaedics. I ultimately decided to go with Ortho, and I was SO GLAD because it was a magnificently busy night and I got to see and do many things I had never done before.
I started by following the 2nd year resident in the ER. He had a couple of patients with vertebral fractures, where the most I could do was: a) help the nurses turn them so that the resident can do the spinal and rectal exams and b) go get random info from the patient if the resident has forgotten to ask them something. Both of the patients were pretty lucky (as lucky as possible given that they had vertebral fractures) and neurointact, which means that they're treated with rest and bracing until their bones get sticky.
We went to the OR to place an external fixation on someone whose tibia looked similar to this:
even if you don't regularly read x-rays it's obvious that his knee was pretty fouled up. I got to help put on the rods and clamps, and then cut the pins using a giant pin-cutter (seriously. about as long as my torso).
Later they let me scrub in on a radius fracture that needed to have a plate and screws put on. The 2nd year resident had to go take care of a patient who was post-op, so It was just me and the 4th year resident (and the attending supervising). I was pretty happy about that already because it meant that I got to see clearly and touch a lot of things (like retractors... oooh!) but then they let me drill the last two holes and place the screws! That's something usually taught to PGY2s. And I didn't f*$# it up.
I also got to finish the stitches. I tried to pretend that I'd never done it before (I only have once on a patient) so that I would look like a stitching savant, but it didn't work and I ended up admitting to citrus practice.
The rest of the night was a little anticlimactic after getting to use power tools, but it was still informative and hands-on. As the 2nd year resident got busier I was able to help with more things; two sugar-tong splints, irrigation of an open fracture and 2 posterior+U splints for a guy who crashed his motorcycle and was on the way to surgery. There was also of holding/pulling on a limb for ten minutes at a time. The physical work of holding isn't really that bad; the hard part is continuing to pull hard on an old lady's arm as she hollers in pain because her bone is being re-set. I got some hateful looks for sure.
My night (morning) ended with breakfast from Taco Cabana, as all good late nights do. I can highly recommend the potato and egg breakfast taco with pico de gallo and salsa verde.