4 Wheelers and a Gut Case

Beep! Beep! Beep! Beep! Beep! Beep! "Crap."

I get the page and leave a hot supper of steak, mashed potatoes & gravy and...... Five miles and seven minutes later, I find a scared 10 year old boy in ASU. He wrecked his four wheeler around four hours previously, skidded across the handlebars and onto the ground. He brushed the dust off, and got back on to continue riding. Tough kid. As night began to fall, he realized his stomach was hurting more and more. He told his mother what had happened as he collapsed on the porch. She brought him into the ER. The call team was paged.

The boy was scared, really scared. Tears were building up in his eyes as he contemplated what lay ahead. I told him "Look, I'm Xavier. When we roll you in there, we will all be wearing masks, but you can pick me out because I will have this red spot on my cap." I stuck a red dot on my disposable paper scrub cap. "I'll be right there, I'll take care of you." The boy smiled faintly and nodded his head. I told his mother it was time, and after a bit of pre-sedation, I rolled him into the suite.

We were looking at an exploratory lap........Basically you slice the abdomen open, and go in looking to see what you can find, and fix it as you go. In such a surgery, the bladder must remain deflated to minimize risk, so the patient must be catheterized. We transferred our patient to the OR table, and I stood over the boy and smiled as he succumbed to the anesthesia. Once he was intubated and his eyes were taped closed, we really went to work.

I threw up his hospital gown, and I pulled down his sweat pants. Boxers. I pulled down his boxers. Safety man here.......He was wearing briefs too. I pulled down the briefs and opened the Foley cath kit. I use plenty of lube on a male, the urethra is longer. I quickly catheterized the boy, and I prepped him from mid-thigh to nipple line. My partner draped him as I went outside to scrub.

The case was a complicated one. His small bowel was perforated in multiple places, with trauma throughout. He needed a resection. He was fortunate in that he did not receive a colostomy, I suppose.

It was a long surgery, after a long day of surgery. Once completed with the incision dressed, I removed the Foley catheter, transferred him onto a bed, put a warmed blanket over him, and quickly rolled him into recovery. I gave report as the surgeon went to talk to the boy's parents. It would be an hour or so before the boy remembered anything. I went to help my partner clean the suite, and to assist the new RN circulator in her documentation.

It was dark, with bugs buzzing in the parking lot lights as I left the hospital. Shortly, an early morning would be upon me, full of ortho cases. I needed sleep. I was listening to Smokey Robinson and turning into my driveway when I realized.............I had not pulled up the boy's britches......All three pair were still around his knees......I used plenty of KY to prevent chafing on catheterization.....The last face he saw was mine, with a red dot on my head, saying "I'm going to take care of you."

No, I did not drive back, I got on my cell phone to my recovery nurse, and she saved my ass. Thank you Shelia, you're a doll.