Spinal Tap

Just got off my first ER shift, and all I can say is... Holy blood draws! I lost count of the IV's and blood draws I did. It was a fairly slow night in the ER so we were pretty much just helping out the Nurses with IV's, and doing physical assessments with the Docs. There was only one trauma patient tonight who came in with 3 GSW, (gun shot wounds), one in the lower back, one in the right bicep, and one right above the knee which went straight through his femur causing obvious deformity- his leg was at a right angle when he came in. I was hoping to get a chest tube, but it wasn't necessary as the lower back wound didn't penetrate the pleural cavity. The highlight of my evening came when one of my patients presented with a stiff neck. She had no fever so I figured it was probably simple musculoskeletal aches and pains, but the Doc wanted to be absolutely sure it wasn't meninigitis, so he called for a lumbar puncture in order to see her cerebral spinal fluid. Guess who got to perform the procedure- moi. I located the iliac crest, found my plumb line for L4 (lumber 4) and inserted this huge needle/catheter into this lady's lower spinal column, and retrieved some spinal fluid. Once it started dripping out of the catheter, I could tell it was normal, it looked like water. It was so cool! Doc Rob was impressed with my confidence and aggressiveness, as most interns trying that for the first time are pretty scared. As a matter of fact, the young intern assigned tonight was making fun of me b/c I was having trouble with some of my IV's, but had no problem with a lumbar puncture. She claims to still get quite nervous with those. Oh, I love medicine! So, there is my first day in the ER. More soon.