Not Enough People in the Room During Trauma


 
 It was a frightening scene in NYC this weekend when a trauma resuscitation had to be temporarily paused.  The resuscitation clerk take role noted that less than 45 people were present in the trauma bay and slammed down the large red button labeled Code Goat Rodeo.  Life saving resuscitation efforts were ceased, and the physician running the resuscitation demanded a roll call.  The team was 2 medical students, 2 nursing students, 2 bed bugs, and 2 people wearing ties short of a full resuscitation team.  Fortunately, they were able to find the required team in short order, but this brings up an important point.  The bulk of the trauma literature clearly shows that favorable outcomes are directly correlated to the number of people present in the trauma bay while enough room to maneuver, the ability to hear yourself speak, and a low risk environment for body fluid exposures / needle sticks are inversely correlated with favorable patient centered outcomes.
It is postulated that the heat and humidity generated by masses people saturated with sweat beneath plastic aprons and facemasks creates a favorable environment for the patients.  In addition, it is believed that CPR quality drastically improves if it is being performed in front of a crowd of cheering fans.  Finally, there is some evidence that the general chaos created by overcrowding the trauma bay (n=45 people) helps recreate the environment at the scene, thus orienting the victim and improving mental status.  We at ThePannus.com recommend having designated runners available at all times.  If a Code Goat Rodeo is called, the runners should split up in all 4 cardinal directions.  Their training should include finding the following people: lost medical students to serve the classic trauma roles such as space takers, noise machines, and path blockers.  Obese/sweaty people are known to be excellent humidifiers and odor creators but are notably space inefficient and can make the 45 body minimum even more difficult to obtain.  Occasionally, drunks are the best cheerleaders (CPR motivation).  But experts quoting the evidence recommend that above all, sheer numbers of people are essential for favorable outcomes in trauma.