level 1 Trauma SICU

Conrad283, BSN, RN · Aug 28, 2008

what can one expect in a trauma SICU? What type of pt's, equipment...etc?

The hospital where I work is a Level one trauma center. I have only been working as a nurse in SICU for 4 1/2 months now, I let me tell you I have seen my fair share of interesting stuff.

Just as I started, there was a patient who was run over by a 30,000 pound front loaded (bulldozer), by one of the back wheels. He initially had an ex-lap to which they noted he had a liver lac, a bad one. He remained very unstable for quite a number of days. He was quite a miracle that he was able to walk out of the hospital alive after roughly 4 months.

Another patient had a left thoracotomy, and everything went fine, and he was discharged home a couple of days later. 9 days post-op, he came back to the hospital with SOB. He was initially on the med/surg floor, but was transferred to telemetry. He started to crap out up there and they were going to intubate him and do a bronch to see the cause. He wound up coding on the way down. They went to put a chest tube in, but his left chest was filled with blood. They wound up doing an open thoracotomy at the bedside. Luckily for me I was on the correct side and got to see all the way down to his aorta (awesome!). The patient had ruptured his pulmonary artery and basically exsanguinated, really sad.

There's amazing stuff and sad stuff that happens in a trauma ICU.

There was one patient with 2 ostomys, 2 jp drains, chole drain, who would walk around the unit with pt.

You can see, swan ganz caths, alines, TLC's, picc lines, ostomys, jp drains, open wounds, broken bones ... just really really critical patients.

But it's exciting and I learn something new basically everyday.

night_owl_504 · Aug 28, 2008

thanks for the reply. im just wondering if i would like it being that im a heart nurse. i know theres a lot of neuro, but i just wanted to see others experiences

meandragonbrett · Aug 28, 2008

We have LOTS of:

ICP Bolts, Ventrics, Swans, A-lines, central lines, vas caths, ex-fix, traction, halos, ETT/Trachs, multiple bedside surgical procedures, afferrent and efferrent drains.

We use LOTS of:

fentanyl, midazolam, morphine, hydromorphone, lidocaine, amiodarone, epi gtt, norepi gtt, cardizem gtt, vasopressin gtt, NaHCo3 gtt, dopamine, dobutamine, phenylephrine, vitamin K, electrolyte replacements, propofol, norcuron, labetalol, metoprolol, heparin, THAM.

Our most common dx are:

Liver Lac, Kidney lac, s/p nephrectomy, aortic dissection, carotid dissection, SAH/SDH/IPH, rhabdo, ARDS, SIRS/Sepsis/Septic Shock, and MAJOR orthopedic injuries.....to the extent you think that these folks will never sit up for a year at minimum.