Okay so today is my day off (ha!) in which I have to attend lectures/grand rounds for ER residents. So I listened to a few good lectures then i was told we were going to attend trauma lab (dun dun dun!).
We were lead down a labyrinth of hallways lined with pipes and broken 70s tile. The woman pointed to a stack of paper gowns, hats, booties, and other surgical coverings and told us to 'gear up'. We were then divided into teams of 3 and lead into a sterile room with two steel slabs. There are two human-sized, hairy pigs laying upside down tied down with a tube coming out of their mouth.
A dorky, gangling guy in bright blue scrubs, who I assume is in charge, walks into the middle of the room. "These pigs are anesthetized." Without hesitation he leans over grabs a large cleaver and stabs one pig in the chest 4 times and then grabs a bat and smashes the other pig a couple times as hard as he can.
I fight off this wave of nausea and suddenly got really sweaty under my green latex gloves. I am trying not to think about the crunching noise of the pigs ribs or the twitching of his legs. I am thinking don't get sick, don't get sick.
"What are you doing standing around? SAVE YOUR PATIENTS!" The guy yells pointing at the injured pigs.
Suddenly the room lurches into motion and everyone swarms around the pigs. I don't even realize what's going on, but I am moving without thinking- standing beside the stabbed pig. Its' blood is throbbing and spurting out the stab wounds, its obvious the heart and lung was punctured. I look up because this girl is handing me a scalpel to do a thoracocentesis (pop a hole in the chest wall to release the air that is preventing the lung from inflating). I'm kinda nervous because its not like I've ever done this procedure or seen one or even really paid attention to reading about it. The other team is frantically moving about and my team members are splitting open the chest to try to stop the bleeding from the heart (which we have to visualize). So I take a deep breath, find the intercostal space and make the incision. The muscle twitches and warm blood trickles down to pool on the tray. I shove my finger in the hole trying to find the appropriate space to get through the muscle. I put a hemostat in the warm muscle with my finger and spread them apart hoping that this is the appropriate technique. The girls are now shouting because they are pulling apart the rib cage on the other side of the pig- the hole is smaller than we thought, which makes it harder to plug up. They need me to hold some things open. I shove a plastic tube in the hole I've made and wait for the barely audible rush of air before i struggle to throw a few stitches around the hole i've made so the tube doesn't slip out. I then rush to wrench the metal contraption that is holding the ribcage open. The purple red heart is pulsing furiously, the phrenic nerve is beautiful! They insert a foley and inflate it to stopper up the heart temporarily. She says we need to establish an airway since the heartbeat and become unstable. So they hand me the equipment and keep calling me Crystal which I don't really correct at the time.
The man in blue scrubs comes to observe our table and shouts at me "to get it together." And i try to insert the tube down the pigs throat. In the meantime, one of the interns at the other table shrieks while a spurt of blood shoots at the ceiling and narrowly misses my paper cap. And I slipped, the tube enters the esophagus and I have to pull it out and retry. I try to ignore the fuss happening at the other table as they urgently buzz from one side of the table to the other. The intern at our tables also began to yell as blood began to seep past the seal. I didn't see what exactly went wrong but soon the blood began spurting and I failed intubating a third time. I attempted a cricoidotomy but failed just as the last of the seal broke off. The blood was flowing freely now and had stopped spurting so much as oozing. We realize that we are in deep here and somebody shoves me outta the way and fixes the airway. They ask me to help on a femoral line to get a pacemaker in but before I am able to get the equipment the man in blue scrubs demanded we call it.
He promptly berated us and demanded we discuss what went wrong. He demonstrated the use of a transcutaneous pacemaker on the quivering heart that still oozed despite the lack of fluid pumping through its walls.
It was only at this point I explained I didn't know who Crystal was and that I was only a third year student. The man in blue scrubs was the third year resident and he said we did alright considering. The pig was given some extra drugs to make sure he would never wake up.
I stayed afterward and sewed him up. I wanted to give what thanks I could for the life he gave. I truely hope he didn't feel out botched central line attempt or our interosseus femoral line or any of it. Plus it was good suturing practice. So thanks piggy.
So a bit of of history.... (because i had to ask.)
I found out this has been done one time a month since the 70s. They used to use dogs, but pigs are more anatomically similar to humans. This activity is approved by the animal rights people. I was told that we justify it by knowing that as future physicians in this scenario we will use this information and would rather practice on a pig rather than a real human.
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