At any given time, there’s usually either a pharmacy student or pharmacy resident hanging out in our ER.  This particular month we had Kipp, a pharmacy resident who was eager to see his first trauma.

At the end of the first week, he finally got his chance (it was a slow month). We stood in the trauma bay, waiting for a fairly routine-sounding MVA to be rolled in — positive LOC on-scene but now conscious with a GCS of 15, along with an open tib/fib fracture.  Pharmacy-wise, this patient wouldn’t require much: antibiotics, tetanus vaccine, and maybe some pain meds.  No intubation meds, mannitol, or anything fun like that.

Kipp: A few months ago, I went and saw the movie 127 Hours at the theater. It was awesome. When they got to the part where James Franco had to cut off his arm, I watched the whole thing. Other people were closing their eyes and looking away, but I’m like, “This it’s nothing!” My favorite part is when he plucked the nerve in his arm like a guitar string…

And then EMS brought in the patient. Unfortunately, the leg fracture was just a regular old closed fracture, so I couldn’t make this resident do the aminoglycoside dosing. There wasn’t even so much as a laceration to deal with.

Cranky Surgical Attending: Pharmacy, can we get 50mcg of fentanyl?

Kipp: I got it…

As Kipp went to the back of the trauma bay to pull fentanyl out of the Pyxis machine, I chatted with one of the respiratory therapists. Suddenly, there was a loud crash, as metal carts and trays were upturned behind us. I turn around, and there’s Kipp, slumped on the floor next to the fluid warmer.

Apparently the lack of blood and guts was just too much for his nerves of steel to handle.