Skid Row

One afternoon the ambulance crew delivered a twenty-seven year old female to our emergency room. She and her husband were returning from a funeral when the A-frame fell out from under the front of 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 panty hose were the toes and waistband and the waistband of her panties. Everything else had been ground away from the roughness of the pavement. Her back and inner surface of her legs had a heavy case of “road rash.” Road rash are dirty abrasions that occur from falling or sliding on a road or on 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 and dirt filled wound.

As we cleaned her scrapes and were picking pieces of gravel and dirt from her wound we noticed that the abrasions ran from her heels to her upper, inner thighs and even into her vagina.

Once her wounds were clean, we started to cover the abrasions with Silvadene cream and to apply bandages. They were bulky, difficult to keep in place, and wouldn’t cover those wounds inside of her vagina.

I began to think, “How was 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.”

The doctor followed me as I went back to help with the bandaging. He re-evaluated the wound and called her family physician. He made arrangements for us to insert the indwelling Foley catheter and have her admitted for pain control.