 So I had a question last week after I went through what is really done in a 24 hours shift. I had a question about what does the PA do as opposed to the physician, like who's running the trauma? So I wanted to address that for you, just kind of give you a step-by-step on exactly how that comes in. So we have pagers and beepers or whatever in the hospital. I know if you've seen any hospital show, they're running around with pagers. That was back in the 90s. It's not really a thing anymore, and people are walking around with pagers, but it's a thing in the hospital if you are on the trauma service or any of those kind of subspecialties where you would have an emergent surgery. So we have these pagers that we carry around, and then we all have iPhones that we can communicate with each other with. And if a trauma is called, it will be called overhead, and then it will also beep to the pager, to the beeper. So we would know exactly what it is, and the beeper, because overhead, all they'll say is trauma level one or trauma level two. Trauma level three, we don't have to respond to that can be handled by the general ED. So on the pager itself, if you've ever seen a pager, you can actually go through and look and it will have a message on what exactly the trauma is. So is it a fall? Is it a stabbing? Is it a gunshot wound? Is it a motor vehicle accident? Because those are all the things that we typically respond to. So depending on what it is, there will already be a PA downstairs in the trauma bay. So there are three trauma PAs currently now on staff. One typically deals with general surgery stuff. One will be down in the ED trauma bay, so that when the trauma comes in, they are there ready to address that trauma. And then there is a floor trauma PA to deal with all of the traumas that has come in like over the past few weeks that are still on our service. So when the trauma comes in, the PA is the one that is really directing the care. So when they come in, like everybody is there, you know, we have our nurses, our techs. Depending on what kind of trauma it is, is it a trauma one? If it's a trauma level one, then every, like the room is completely packed. You have respiratory therapist. You have x-ray. You have the ICU team. You have anesthesia. You have the PA and the surgeon, the trauma surgeon comes down as well. You also have residents that will come in to help on trauma level ones if they are like working that day. So it's a packed room, but if it's a level two, then it's really just like the PA, your nurse and your tech. So what will happen is the ambulance will bring like the EMTs or, you know, the like the helicopter troopers, if they're the ones that are flying in the trauma, they'll bring the trauma in and they'll be like, okay, are you guys ready? And then we're like, yeah, ready. And so what happens after that is they will now give us the information of what happened. Like, what did they see when they came on the scene? What was the report that they got? So we're taking all of this in as the trauma PA. And again, we are the ones that are running that trauma. So they'll come in, they'll be like, you know, 70 year old male involved in a motor vehicle accident. They were the belted driver, airbags deployed, you know, they have to be extracted so you're getting all this information to see how badly this trauma was or is. You want to know things like how fast the car was going. Like I said, if they had to be extracted or if were they self extracted. And so as you're taking that information and you're going through your ABC like DEs of your trauma and so you're looking at airway, you'll ask the patient a question, you'll see if they respond, you'll see, you know, if they know where they are. And with that, you're getting your airway section of things to see if their airway is patent and protected because if it is, then they'll be talking. Everything is fine. If they're not, then you're like, OK, like we likely need anesthesia or something like that because this person's not talking. But you're taking all of this other everything else into consideration. Now, while you're asking the question, you have the nurse that's there getting ready to hang the IV. The tech is actually like starting a line where if I'm there as like the trauma three that's coming in like I'm like pulling off clothing, you know, pulling off shoes, putting them in their own like kind of property bag. Kind of we want to get like the patient pretty much completely naked so that then we can like we'll put like warm blankets on them. But we want to be able to assess everything. And so after you do airway, you'll go through breathing. You'll check their lungs. Make sure that you hear breath sounds on both sides. Because if not, then you have to put in a chest tube. You have to do a thoracostomy right there, right? And an urgent one, I guess you could say. Because you want to protect that person's breathing as well. So we're listening for all of that stuff. You're going to check circulation. So you're checking all the pulses, seeing exactly like what's going on with them, you know, like their disposition. And that's where you're getting like all of these. And that's D for the, you know, the ABCD that's disposition. So you're going to be sitting up here like looking at, hey, like what's their GCS, their Glasgow Coma Scale? Like are they responding to your questions appropriately? Are their eyes opening spontaneously or not? You know, do you have to like rub them to a sternal rub to actually get them to speak to you? Are they moving all of their extremities, that kind of stuff. And then you want to like just kind of check out the environment, right? So you want to look for any wounds, like any puncture wounds, where they're at, assess that. And again, the PA is the one that's doing all of this. Because there's usually just one physician on at a time. There will be like a second one that's like on call for help if you need. And then there's always like an ICU trauma physician so that they're there to help as well. But the main trauma physician for that day, they're doing like a whole bunch of other stuff. They might be in surgery, you know, they might actually just be rounding on the floor. I like it can be a plethora of various different things that can happen for that one physician to take care of. So that's why there's the PA there to run that trauma. When they're free, they'll come down. They'll check in on the trauma. But again, the PA is the one that is kind of directing that whole care. And so we're putting in orders or taking them to CT scan, you know, obviously giving them pain medication and just kind of deciding what happens next with this patient after you've kind of gotten the patient stable. You'll give report to the physician. Now, if the patient is not stable or crashing, like you're immediately calling the physician to be like, Hey, this patient is not stable. I need some help. Like I'll post them or we'll take them to the RL call or let's get bloodless. You know, you're all of these various different things are running through your head of things that you need to do again, because you are running the trauma. So I just kind of wanted to make that clear that the PA is the one that's running that trauma, although you do have the attending that is actually like, you know, the head of the trauma. They're the ones that are getting reported and things like that. You have to know exactly what you're doing and how you're assessing this patient because you're the first one that the patient is seeing. So it can get pretty hectic, especially when you have like more than one trauma coming in at the same time. Or if you have like, let's say everybody was in the same car and they bring all of them to your hospital. And so now you have like three traumas that came in exactly at the same time, not like five minutes later. So it can get hectic. And that's where you need all hands on deck. I don't know if you guys have ever done like a CPR or BLS class where they talk about like knowing your role and, you know, effective communication and closed loop communication. So making sure that like, if I say, hey, give them, you know, delotted or something like that. And I'm like, or fentanyl like 50 micrograms of fentanyl or something like that. Then you have the nurse that repeats that back. Okay. Pushing 50 micrograms of fentanyl. So you want to make sure like everybody knows their role and they're doing exactly what they're doing because you don't want there to be any mistakes. Right. You know, you don't want this trauma to now start decompensating because of a mistake that you made in terms of like just understanding what the order was or not doing exactly what you're supposed to do or not knowing your role. So you're making it more difficult for the person that's trying to do the ultrasound because you're like trying to take the ultrasound somewhere else. So it's a very interesting position to be in. But like I said, just to answer your question, the PA is the one that's running the trauma. Ultimately, the physician is overhead of all of the traumas, but they have various different things that they'll be doing throughout the day. So you have to know what you're doing as a PA to make sure and ensure that that trauma like makes it through and can actually like go to the floor and all of that stuff. But that's typically how the trauma aspect of being the trauma PA is ran. The trauma comes in, you assess them, you do everything that you need to do for them, you stabilize them. And some of these traumas can either go home and be discharged home the same day. Some of them may have to stay for one midnight, just kind of in like an observation status. And then some of them will actually have to be admitted for multiple days and sometimes even weeks and slash months. So it all depends on the severity of the case, but that is how the trauma is run and that is who's running the trauma. So hopefully this answered your question. Please go ahead and like this video and subscribe to my channel. It really helps my algorithm out. Thank you guys again for this 30k. I will address it later on in this month because this is a big month for us. Like 30,000 subscribers is great. So we'll have a celebration a little bit later when things kind of die down in our country. But I hope you guys stay safe out there. Keep yourselves and your family protected and make good, smart decisions. Thank you guys so much for watching. I will talk to you guys next time. Bye.