Saturday, September 14, 2013

When the A Frame Falls Out
An ambulance delivered a twenty-seven year old female to us. She and her husband had just attended a funeral and were returning home when the A-frame fell out from under their car. The car lurched sideways, the passenger door kicked open, and she was thrown out onto the asphalt roadway. She skidded along the tarmac for several yards on her backside.
All that was left of her underwear and panty hose was the toes and the waist band. All else had been eaten away from the roughness of the pavement. The back and inner surface of her legs had a heavy case of “road rash” The dirty abrasions that occur from falling or sliding on a road’s surface or gravel.

After the doctor examined her, he was kind enough to have us medicate her for pain, before we began the daunting task of cleaning and dressing the expansive dirty wound.
As we cleaned her, picking pieces of gravel and dirt from her wounds, we noticed that the abrasions ran from her heels to her upper thighs and even up into her vagina.

Once her wounds were clean, we started to cover the abrasions with Silvadene cream and tried to apply the bandages. They were bulky, difficult to place, and would not cover those wounds inside of her vagina.
I began to think, “How is she going to keep the bandages clean when she has to go to the restroom?”
I told the other nurses to stop for a bit. “I need to talk to the doctor.”
“Doctor,” I said. “Did you notice that those abrasions went up inside her vagina?”
When he didn’t answer, I continued. “The first time that woman passes her urine, she’s going to come back in here and punch you right in the face.” Everyone knows what it’s like to get sweat into a scratch. This would be even worse. “You need to stick a Foley catheter into her for a few days until she has a chance to heal.”

Dr. Jaimie followed me as I went back to help with the bandaging. He re-evaluated the wound. He called her physician to get the okay for us to insert the catheter and have her admitted for pain control.

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