At the trauma center I used to work at, triage was usually short, sweet, and to the point. There was rarely in-depth examination, more so a quick glance-over, then tests (x-ray included), and then comes the more thorough examination.
On this specific day, I was running the "chest room" in the department (bet'cha can't guess what we x-ray in there). I had a patient come in wearing a TB (tuberculosis) precaution mask. His paperwork said that he was coughing up blood...so they had sent him straight to me for an x-ray to confirm the TB. I took the two views...one front to back and one side to side, and went out to develop the film.
When the first one came out, I saw a strange lucency that I couldn't quite make out. Then the second view came out...
...this moron had a SIX-INCH SERRATED KNIFE BLADE IN HIS CHEST. I immediately ran to the radiologist, who called the police (we have to do so for any stabbings or gunshot wounds). The radiologist went with me back into the room, where we had the man remove his shirt to expose a sucking chest wound in his back that had been covered-over with a Band-Aid.
After the cops arrived, we were able to piece together what happened to twit-boy. Turns out that he had robbed a woman that past Friday (this was on a Monday night). As he was leaving through her kitchen window, the woman caught him and stabbed him with a knife. Since it didn't kill him, he had a friend SAW OFF THE KNIFE HANDLE, and figured he'd just live with it for the rest of his life...much like shrapnel. Yeah...no. The cops were amazed he was still alive...they had given him up for dead after they lost the trail of blood that went for almost a quarter-mile.
Moral: If you get stabbed, it is not wise to leave the blade inside you. This is especially true if the blade is IN YOUR FREAKING CHEST.
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The first xray I saw when I was an xray student was a head xray of an air plane crash victim and the head was in splinters. We all made copies of it. Bizarre, I know. Other things that we found were bizarre but interesting were; a guy that was attacked by a bull and his hand was missing and his forearm was bit clean off at the distal end. Knarly. Another was a car accident on New Years Eve when I was a 2nd year student, 2 guys and I was doing portables in the ER and one's head was cracked like an egg. The other's lower leg was broke mid-shaft and it bent both ways. Messed up my first year student. Passed out in the hallway outside the trauma room. Married her :)
Other things I've seen that most of you haven't.....Parotid gland xray. The patient sucks on a lemon which sucks the juice from the gland...then a very thin catheter is introduced into an almost impossible opening inside the cheek and a small dose of radiopaque dye is injected. Very painful. This was in the early 1970s, around '73. Another was an injection of dye into an infant, probably 1 year old, for an IVP into 2 humps in the upper back subcutaniously.
Had to burn as it has iodine. Only saw that once. Must've been accepted protocol at some point. Kid screamed as I would have imagined. Damn..... Later in the early '80s I did myelograms with an top shelf Neurologist that smoked a pipe throughout the whole study.
The coolest thing about our profession is.....they send us a patient, just after triage and we get/have to figure out the real damage. But I always loved KNOWING the poop before anyone else did. And you get to call the ER doc and tell him. Love being the first to know. Lung down, tension pneumo, subdural bleed, get your ass back here and look at this shit!!! Nurses will never get to experience that. Had one that had rectal bleed and the KUB showed 6 radiopaque well-defined squares/rectangles within the colon. Well, everyone gets an opinion and I told the ER doc I thought it was glass, as glass has 5% lead, just enough to be visable on xrays. The radiologist read it as residual barium from a recent bowel study, altho there wasn't one. The night service confirmed what I said. About 3 days later, the poop came out and it was GD glass. Idiot had eaten glass to cause bleeding and get pain meds. Why am I not surprised????/
I've Xrayed probably 4 dead bodies, sometimes to help the medical examiner to decide suicide or murder. But the first was a 3 year old black child I xrayed in the morgue and I didn't know any better but laid his frozen body onto a 14x17 inch cassette and got all of his body on it. The radiologist screamed at me for doing a whole-body xray. When I told him the child was deceased, he was shocked and said he couldn't tell. There was air in the trachea. I hadn't made a note to that in the history. From that point on, I learned how important the history is. It was a child abuse case and he needed to know that. Tough lesson to learn.
Closing for now....Just so you know, I've talked 3 nursing students into changing their major from nursing to Radiology. Nursing is an honorable calling but it's thankless. Doctors that can't write english, families that you can't please. Patients that suck all your time and you can't win for 12 hour shifts. On the contrary.....
....Xray/CT techs will spend no more than 30 minutes with a patient then they're done. You don't have to fight with the family. Doctors that wanna fight, you refer to the radiologist, if he/she's available. Can't tell you how many doctors ordered IV contrast CTs and the renal labs were so far out of whack that if it wasn't for you checking then you'd have killed someone. Boggles the mind. UGH.....
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