Spiking Fevers in the Trauma Room

Lying on a stretcher in the trauma room, I was surrounded by a mass of controlled chaos. I couldn’t believe how quickly my day had gone downhill. My body was wracked with chills, and I was unable to stop my teeth from chattering. Even though I had my Hello Kitty comforter with me.

“Can I have a heated blanket or at least another thick blanket?” I asked.

“Are you kidding?” One of the trauma room nurses asked me. “Your temperature is 105.5 and climbing, we may have to pack you with ice packs to get this fever down.

That thought horrified me. I felt like I was in Antarctica with just a bathing suit on. It felt like I had gone swimming in the frigid ocean waters in that bathing suit. Somehow the ice-cold Antarctica waters were getting inside my bones and organs.

Having a Central Line Placed in the Trauma Room

The doctors knew I was going to need another central line placed as soon as they saw me. It was obvious by my vital signs and preliminary bloodwork that I was septic. This meant I was gong to need a bunch of antibiotics and extra IV fluids. I was going to need IV Tylenol, and IV medications to bring my blood pressure up. My port was not going to be enough to handle all those extra intravenous meds and fluids.

“We have to place a triple lumen IJ line,” one of the doctors in the Trauma Room explained to me. I vaguely nodded as I floated in and out of a very sleepy state.

For placement of a new central line, they normally would have taken me to interventional radiology. Interventional radiology would normally order me either IG sedation or full anesthesia. However this was being done on an emergency basis in the trauma room. They had no time to take me to interventional radiology or order me IV sedation or anything like that.

When Lidocaine Doesn’t Work Mid-Procedure In the Trauma Room

Instead I lay there in the middle of the buzzing room. The trauma room doctors pulled huge lights over me. They scrubbed my neck with alcohol (I’m allergic to chlorhexidine and betadine which is what they would use to clean most patients’ skin with). Then they covered me with sterile blue sheets. While some nurses and doctors were doing that, others were putting together a sterile field. They used a gleaming metal table covered in its own sterile blue sheet.

I felt the sharp sticks of Lidocaine going in all over my neck. They burned and then weren’t worth it. The Lidocaine didn’t really work the way I would have hoped. Maybe they didn’t wait long enough for it to take effect, but they couldn’t. My blood pressure was rapidly dropping as my heart rate was spiking and my fever was nearing 106 degrees Fahrenheit.

“You are going to feel a little pressure now,” they warned me.

I felt way more than pressure when they made the incision to thread the tubing in through my neck. . As they advanced the guidewire sharp pains shot through my neck and chest. Then I felt the oddest and most uncomfortable full sensation in my neck and upper chest. 

Trauma Room Procedure Torture

The worst part was when they got inside my chest.

“We have to tap your collarbone with the needle to verify placement. The lidocaine can’t numb that area.” one of the trauma room doctors explained. “So it’s not going to feel very good.”

I wanted to tell him that the lidocaine hadn’t worked anyway. How much worse could it be? But I couldn’t talk because the pain was too intense. That was when I realized that the lidocaine must have been doing something. They tapped that needle against my collarbone and I almost rocketed off the stretcher. I screamed my head off until that part was over.

Feeling Every Single Stitch Go In

Then I felt intense pressure and pushing and pulling sensations. Those sensations seemed to last for hours. I could tell that they were having trouble placing the line. This stressed me out. What was going to happen to me if they couldn’t place the line. If my body had been able to produce sweat, I would have been drenched.

Finally, I heard the magic words.

“Okay, we have the line in, now we just need to stitch it in place,” announced one of the trauma room doctors. By the time they were stitching it in place, the lidocaine had completely worn off. I cried out in pain as I felt every single stitch and begged them to give me more lidocaine.

The Controlled Chaos of the Trauma Room

“We only have a few stitches left. Just let us finish it will be less painful than injecting you with more lidocaine.” they insisted.

I disagreed, but they didn’t care. So I just kept screaming every time the needle went in and out of my skin. It was only a few stitches, but it felt like hundreds.

Once the IJ line was in, the trauma room nurses hung bags and bags of fluid. They also drew blood and blood cultures. The fluid samples would show them what bacteria or fungus made me go septic. Nurses kept coming back at me with blood draw trays and draw more and more blood out of one of the lumens of my triple lumen central line. After about an hour of that they had drawn so much blood that I wasn’t sure I had any left.

Then one of the trauma room techs inserted a Foley Catheter.

UTIs and Foleys Are a Painful Combination

Again, without meaning to, I screamed in pain. UTIs make catheters feel like instruments of torture. Once the catheter was in, they took a urine sample from it. The urine culture along with the blood culture would give them a ton of information. They would both confirm what bacteria or fungus had made me go septic. It would also provide crucial information on what antibiotics would be the best ones to treat it.

Somewhere Between Awake and Asleep

The whole time I was in the trauma room, I felt like I was fading in and out.  One second, I was in the Trauma Room, aware of everything around me. The next second I was in bumpy darkness. Then I was viewing the world through foggy cloudy lenses. Seconds later, I was forgetting where I was and feeling completely disoriented. I would look around and not remember who I was, where I was, what was happening or anything. Eventually I would reorient to reality.

Moments later I would start thinking about memories of other times I’d been in the trauma room or otherwise critically ill. This would cause me to fall into a dreamlike state where the memory would play out in my head. I would be in the middle of the memory like it was vividly happening to me again. Then I would reach up to grab at stuff and my hand would just hit the air. Only then would I come to and realized I had just had some sort of half-awake dream.

Hours later I was finally stabilized enough to be transferred from the trauma room to the ICU.