A Trauma Case That Defied the Odds

When a 22-year-old man arrived in the emergency room at a Long Island hospital after a motorcycle crash last September, Caitlin Eyerman, DNP, CRNA, knew the situation was dire.

“We were looking at a very unstable situation hemodynamically,” she said. The patient was already intubated and had chest tubes in place. His blood pressure was around 40/20. The team had to move quickly to stabilize him so the surgeons could operate safely.

Some of his existing lines were not working properly, so the team had to secure new access while managing a patient in profound shock. He was wearing a C-collar, which made securing that access difficult. He had already lost two liters of blood on arrival, and on incision, he lost another two to three liters of blood instantly. Eyerman described it as “catastrophic.”

As a Certified Registered Nurse Anesthetist, she had to determine the best way to deliver lifesaving treatment.

“With that much blood loss in a very short period of time, you have to be constantly transfusing,” she said. “And really, to do that as one person is physically impossible.”

She described a room full of people—surgeons, physician anesthesiologists, nurses, technicians, and blood bank staff—moving at once, all trying to stay ahead of a rapidly changing situation.

“Caring for this patient required open communication, constant feedback, and split-second decisions,” she said. “You need to have a whole team of people that are on board and really locked in. In the OR, we were on what we call rocket fuel.”

The patient needed maximum support, with blood products and medications flowing continuously to keep him alive.

“We ran this case on almost zero actual anesthetic, and the patient was not conscious for any of it. We managed him anesthetically in a way that was feasible for his hemodynamics, in a way that would have been safest for him.”

He remained unstable even after the initial surgery. Before the team moved him to the ICU, Eyerman made sure blood was ready at the bedside and the rapid infuser was set up and running. When his condition worsened about 20 minutes later and he became too unstable to return to the OR for an additional surgery, Eyerman and physician anesthesiologist Christopher Wilson, DO, converted the ICU room into an OR. They stayed to manage the massive transfusion effort and support the team as treatment went on.

What stayed with Eyerman most happened after the case. “I was 100% convinced the patient wasn’t going to make it through the evening, despite our best efforts,” she said.

When she learned he had survived the night, she couldn’t believe it.

She went to the ICU to see him, and she visited every single day during his weeks-long stay—something she rarely does with patients. This patient was so ill, and his recovery so unexpected, that Eyerman said she had to see it for herself.

“I’ve never seen a patient survive a case like this, in all my years as a registered nurse,” she said.

When she saw him following commands and giving a thumbs up to the nurses, “it was like witnessing a miracle in real time.”

Eventually, she crossed paths with the patient’s parents. “I told them that their son is destined for something great in this world. The odds were so small of him surviving this accident and having purposeful function afterward. It’s like winning the lottery twice.”

Five months later, the patient returned to the hospital for a ceremony to honor the team that saved him. “To see him was such a wonderful surprise, but also intensely emotional,” Eyerman said. “Not only was he alive, but he was almost back to normal. I’ll never forget getting to hug him and his family and see him now living his life like a typical college kid. It’s absolutely incredible to me.”

She said the case forever changed her both personally and professionally. It also reinforced something that stays with her every shift. “Everybody is somebody’s somebody, no matter where they come from, no matter if they’re a drug addict or they’re homeless or if they’re 100 years old and getting their hip done. Whatever the case is, every person is somebody’s person.”