There has been an RTA, a car has veered over the white lines and hit a minibus head, on there are multiple dead and injured. Then the injured start trickling in, the first and most serious arrives by helicopter, unloaded and the helicopter heads back to get more patients. We start to work on this lady, multiple injuries, where do we start? We know we have to work quickly, not only for her but because we know that more are coming. We know this lady needs surgery, but who goes first? Surgeons or Orthopaedics? We let them sort that out between them and get her to scan then theatre. The next one arrives and then more. It becomes a blur of injuries, tubes, wires, recordings, blood, people calling out for equipment and the various bits and bobs that go into a major trauma. As nurses we divorce ourselves from what is happening, we try to listen to everyone and as a doctor will talk over a plan with a colleague we listen so that we can get the next bit of equipment, yes it can sometimes make you feel a bit like their servant but it is what the patient needs at that time and lets be honest, that is our job. We know where everything is kept and how it works.
After a time it calms down a bit, it becomes less frenetic and we can look around and take stock. We have 4 spaces in our resus room, space 1 has an injured male who is going to go to orthopaedic theatre for various fractures, space 2 is going to general surgeons for exploration of her abdomen - she is bleeding somewhere internally plus has broken bones. Spaces 3 and 4 have dead people in them who crunch when you move them, I hate crepitus, we have not had time to take them to the viewing room. We have time before we have to deal with relatives, they are all from the other side of the country and will take time to get here so we can make the dead presentable. There is blood everywhere, the floor is a mess of discarded packages, swabs and the odd bit of equipment that fell off the trays. My colleague and I look at each other and and think "if our families could see what we do".
All this carnage and so many peoples lives ruined because someone tried to overtake on a corner.