A Day in the Life of a CA-1 at Ben Taub Hospital
Yesterday I was on call and it was a pretty typical Saturday night at "the Taub."
Most people love being on call at Ben Taub because call doesn’t start until 2:30 p.m. on weekdays, and 5 p.m. on the weekends; it's great because you get the morning off to sleep in, run errands, and relax. I arrived around 4:50 p.m. to start checking the airway boxes (our airway tackle box on wheels that we take with us to code blues and airways throughout the hospital); after our call team made sure that airway boxes and stat rooms were ready, I got my assignment to take over a laparoscopic appendectomy from a colleague on the day shift. I received report and took over the case, which, conveniently, only ended up having another 30 minutes or so left. After emergence and extubation, I transported my patient to the PACU, gave report, finished my charting (we have electronic anesthesia records at Ben Taub which make charting really easy), and made sure my OR was ready for a stat case, in the event that one came. By this time it was around 7 p.m. or so, and I was ready for dinner.
I went to hang out in the anesthesia lounge and have some dinner with one of my fellow CA-1s on call with me. We had a nice 45 minutes or so to relax, until we heard "anesthesia stat to shock room 1!" ring out overhead. I jumped up and headed for the elevators to go down to the EC with my senior. As you're heading down for an airway in the shock rooms, you're mentally preparing yourself--at Ben Taub, a level one trauma center, you never really know what you're gonna get. We arrived to shock room 1 to see a flurry of people working on a patient who had been thrown from a bull during a rodeo (stereotypical Texas--right??); he was in a c-collar, which would make my intubation a bit trickier. My CA-3 pushed my meds while I bagged the patient and then intubated on the first attempt--yay! I wrote a quick note in the patient's chart and we headed upstairs back to the ORs.
I got a little time to sit down and relax in the lounge, when another overhead page called out "we have a stat ex-lap for GSW coming to room 11!" I hustled to room 11 to get ready for the patient. By the time the patient rolled in, my faculty, senior and fellow CA-1 were all there to help out. For stat cases, all available people come to help, which can be essential in a really crazy case. My patient was altered, bleeding from his multiple gun shot wounds to the abdomen, and hypotensive--not a great combination. We were able to get him intubated and stabilized so the surgeons could do their part. The case lasted a couple of hours and I transported him to the SICU for close monitoring. By now it was around 1 am and I got to lay down in the call room.
I got about an hour and a half of sleep when I was woken up by another overhead page: "we have a stat crani coming to room 9!" I rushed to room 9 where one of the other CA-1s on call was already drawing up her meds. I helped to get the case started, and once things settled down, headed back to my call room to rest some more.
During the course of the night, I went to two airway calls (the other CA-1s went to the other four), and was the primary anesthesia resident for three cases: the appendectomy, the ex-lap, and another GSW to the leg that came in around 5 a.m. (we had a total of four stat cases that night). The day team came in at 7 a.m. and I was relieved from my last case. Needless to say, by the end of my shift, I was beat! I headed home and took a well-deserved nap.
– Laura L. Staub, M.D.