The Q Word
I've been somewhat remiss in introducing some of my personal characters in my own writing. So here's an introduction to Tess Williams. Usually in stories she's found putting someone in place beneath her, but this story is of her life outside the bedroom or dungeon. And it's sometimes even more exciting.
Please read the disclaimer at the start of this piece. This material is nonsexual but does contain some graphic descriptions of injuries and may not be suitable for all.
Enjoy
The Q Word
By: Aaron Blackpaw
This is a work of fiction. It contains potentially graphic descriptions of grievous bodily harm and medical techniques. These may be traumatic for some readers. Events are a mix of experiences over a decade of prehospital emergency medical experience. I have tried to keep the hospital actions as realistic as possible, but license was taken at a few points (Plus the only time I worked in the ER was a decade ago for clinicals). The characters and story within do not correlate with any person, individual or otherwise. All dosages of medications are INTENTIONALLY INCORRECT. This is not training; this is not reality. DO NOT attempt any actions performed within this story.
With that out of the way, hope you enjoy.
Cool autumn air whipped past the Tahoe as headlights flooded the macadam, sunlight long having faded from the sky. A plume of blazing orange and red autumn leaves followed the truck as the young vulpine pressed further down on the gas. The V8 snarled and growled as it responded, its diet of gasoline and air flooding its lungs and exploding the vehicle forward. Tires droned along the macadam as the road swept right and left. As the road dipped and the truck descended into the valley between the mountains. Oaks towered on both sides of the road, the forests sloping up on one side of the road and down the other, the dying light of the sun slipping through the leave and dappling the ground. As the truck continued into the valley, the radio crackled to static. Trevor reached down, casually resting one paw on the wheel as his other went to the radio. Flailing fingers connected and missed the dial once. He looked down at the radio, wrapping his fingers around the dial and spinning it and sending the numbers on the face of the radio up and down as static continued to crackle.
"Must be a dead zone," He mused as he looked back up mere seconds later and out the windshield.
Two glowing eyes greeted him as the doe froze in front of him. A screech filled the forest as he slammed on his brakes. The pedal beneath his paw shuddered madly as the ABS kicked in. By sheer instinct the fox turned the wheel, hoping to avoid the creature. The vehicle shuddered as the tires left the road, heading up the slope. The fox froze as he felt the world turn, his upper body flailing about as only the web of the seat belt held him to the seat. But that weightlessness lasted a mere moment before he slammed to the side. The screech of crunching metal and tinkling crash of shattering glass filled the night as just as quickly as he had left the road he returned. A shock of pain slammed into the fox even before the sound.
The roof rack dragged along the pavement as the truck slammed back onto the road. Skidding and twisting, the truck slid across the road before it hit the embankment and rolled back onto its wheels. As the truck finally stopped, the fox was completely unaware of even what had happened, where he was, and that he had pissed himself in the process. His world faded dark.
The deer had long since bolted into the woods, completely unaware of the destruction that it had wrought.
BEEEEEEEEP. BEEP BEEEEP.
Lights snapped on in the bedroom as the alert tones dropped and the radio blared.
"Engine 3, Rescue 1, Medic 12, Command 3 respond to Rt. 34-mile marker 45. Single vehicle rollover with entrapment. No further information. Again, Engine 3, Rescue 1, Medic 12, Command 3 respond Rt. 34, mile marker 45. Single vehicle rollover with entrapment. Time out, 2245."
Steps thudded down stairs before doors quickly opened and shut. Quickly donning their gear, crews clambered onto the apparatus as diesel engines growled to life and electric door motors.
"Rescue 1 Responding." The growl of the diesel was overpowered by the screaming siren as the rig pulled out onto the street. The sides of the street were bathed in a shower of flashing and strobing lights as the truck began to accelerate. Red and blue, white and amber bounced off the businesses on either side of the road.
"Clear. Rescue 1 Responding 2248. Highway patrol's going on scene at this time. Will advise further."
"Rescue one clear."
Sharp banter and humor echoed through the cab as nerves were defrayed and minds coming fully up to speed as the fog of sleep fell away.
"Engine 3, Command 3 Responding."
"Medic 12 en route. Coming from St. Damien's."
"Clear. Engine 3, Command 3, Medic 12 responding 2250. Medic 12 has delayed response. Break. All units responding to Rt. 34, Highway Patrol on scene advises one patient, unresponsive but breathing, entrapped inside vehicle."
"Rescue one clear on one entrapment, unresponsive but breathing."
"Damn." Captain Bueller groused from the front of the cab as he hung the radio back on the dashboard. Over the crackling radio, the engine and ambulance echoed his response. Means we get to play medic for a bit." A soft groan met his grousing before he continued. "Whitaker, you've got medical. Everybody else, standard stabilization."
"Yes, sir." The night black lupine in the back seat of the cab responded as he slid the noise blocking earbuds into his ear, slowly rocking his head from side to side as the sound of the engine faded away, the chatter in the cab coming through clearly as the noise canceling technology started up.
Even code, the drive took almost 10 minutes from when the first wheel hit the macadam until the crew saw the blue flashing lights of the state troopers blocking the road. Crimson road flashers crossed the road, blocking it as the rescue rumbled past, pulling up nearly next to the pile of mangled metal that had been an SUV until an hour or so ago as it angled across the road. LED lights blared into existence on the side of the truck as it came to a stop.
"Mitchell, get the generator and hydraulics up then start cribbing. Ray, pull the cutters for now."
Without any hesitation, the crew went to work. Two went to the side roll-up doors on the truck, starting compressors and pumps as gleaming steel tools were pulled and laid on a tarp next to the truck. The other two grabbed the medical bag and Halligan tool and chocks before they headed toward the mangled wreckage as the pair slid on their helmets, one white, one blue and pairs of heavy gloves. Flashlights peered into the car as they got close. Dishevelment and chaos covered the insides of the truck as the Bueller pushed on the car, seeing how it moved while Whitaker zeroed in on the front seat, light playing over the bloody form strapped into the front seat.
As Whitaker came to the car, just from habit, he tried the front and rear doors. The handles didn't even budge, and the crumpled metal and shattered glass made it pretty obvious that opening them would take some persuasion.
"Don't move for me. I'm Mitchell. I'm a paramedic with the fire department. We're gonna get you out of there, but it's gonna take a minute." Seeing not an inch of movement, he waited barely a beat before slipping a hand across the bridge of the fox's forehead.
He felt it move under his hand. The spider web of cracks on the windshield, clotted blood on the fox's head, and that feeling told Mitchell enough of a story to make his choice.
"Cap, see if you can get that back door open. He's gotta go." Whitaker called to Bueller as the area was flooded with light as a half dozen halogen lights lit up as the generator turned over. Blinking for a moment at the light, Whitaker turned his attention to the front seat. "Alright, buddy, whadda we got?" The medic muttered under his breath as his light roamed across the still form as the mental checklist filled itself out. The fox's chest pushed in and out quickly, struggling for air but still working. Reaching through the shattered window, Whitaker pulled off his heavy gloves, only thin nitrile separating him from the dying man in front of him and grasped the fox's wrist and beside his throat. He couldn't feel anything from the wrist, but steady, weak thumping greeted his fingers from the neck.
'Great. Pulse is screaming and pressure crap.' He kept his thoughts in his head, but the grimace on his face would have told the story had the fox been able to see it. Quickly scanning the body for obvious bleeding, Whitaker was relieved to some extent that he didn't see anything, nor feel anything when he swept the fox's thighs. There was blood, definitely, but it wasn't pouring out. Crimson blood stained the blue tee shirt on the fox's chest, fixed and not spreading as dried blood drooled from the fox's nose and mouth.
"Gimme some room, Whit." Another voice caught his ear as he felt a tap on his shoulder. It took only a moment for the last piece of cribbing to slide into place and tires punctured with a lazy swing of the Halligan, settling the remains of the car onto the blocks and fixing it in place. From behind him the scraping sound of metal on glass and metal, accompanied by the tinkling of falling glass as a tool scraped around the rear door's window, knocking out the shreds of glass still clinging to the frame.
"Milton, grab C-spine," Bueller spoke from the other side of the pair. "Door's not gonna come without the spreaders, so window. Got a tarp over the glass in the back."
Whitaker frowned for a moment as he stepped back as the other firefighter moved in, taking the patient's head in his hands and holding it steady as the wolf moved to the back window and slid his glove back on. "Gimme a hand." Leaning into the car, the wolf's gloves landed on the tarp-covered upholster, feeling the pebbles of glass under it as he levered his body up. He felt his legs go up as Bueller helped him slide through the window before twisting his legs under him. "Get me the O2 and mask. Normal collar. Lemme get a better look, and I'll tell you what else I need. Stay there for a moment, Milton."
From head to knees, Whitaker pressed, poked and prodded at the fox's bones, practiced hands moving from one part of the body to the next, methodically looking for what was going to kill the fox, whether in 3 minutes, 3 hours, or 3 days. His paws moved down, finding one thing after another. From a head that felt like a bowl of ice chips to groans and jerking anytime his right chest was pressed to an abdomen that was not normal, the fox wasn't in great shape.
"Captain, See if we can get aeromed. Multiple skull fractures, maybe a Leforte, couple broken ribs on the right and pretty distended abdomen. Think he bounced off the pillar and steering wheel."
As the bottle and mask were passed through the window and slid inside, Whitaker quickly hooked the tubing up, twisting the regulator open and starting the flow of oxygen. Slipping the mask onto the fox's muzzle, he tightened it, seeing the fog of the vulpine's exhalations coating the mask's interior before the vulpine's neck was wrapped in the foam and plastic collar to help stabilize it. As he finished, a hand passed in the end of a tarp, Whitaker quickly pulled it over both himself and the fox before he took the fox's head back into his hands.
"Gonna get a little bit loud in here." He nearly screamed into the fox's ear as a Sawzall bit into the windshield, making short work of the glass. "Can you hear me?"
A groan answered him.
"Can you move your fingers?" He asked further, trying to see just how much of the fox was actually there.
The digits wiggled on both hands, giving him a brief smile as he heard the groan and crunch of steel pincers biting into aluminum pillars as the windshield was unceremoniously wrenched from its mounting and flopped onto the hood of the car.
"Great. We'll be out of here soon enough." The whine of hydraulics was drowned out with the screech of tearing metal as the driver's door was wrenched off with the spreader, the steel jaws biting into the door and pillar and pushing the two apart. More pillars snapped until there were only the two center ones remaining. Held up only by the crews, these two supports were quickly severed, and six men hefted the steel roof off the truck and walked it off out of the way. From the first cut to the dropping the chunk of the truck took minutes, precision and practice obvious in the dance.
The darkness of the tarp was pulled away, glass and metal scattering like confetti and making Whitaker blink as his eyes readjusted to the powerful lights covering the scene. A polycarbonate longboard was already being maneuvered into position as additional hands helped, one pair taking over the head while others ran down legs and slid the fox forward in his seat. In the symphony of controlled chaos, every piece had a part. As the board started to move, Whitaker made a call.
"Hang on a sec." The wolf slid his hand behind the fox, sliding it down his back before pulling it out and helping to guide the board down and behind their patient. Quickly moving out of the way of the seat, the wolf helped hold the board steady as the seat was laid back as far as they could get it. With practiced movement, the crews manipulated the fox and board until they got his entire body on the plastic contraption and attached. A quick lift got him out and onto the ambulance's stretcher and for the first time there was full unobstructed access.
"MedFlight's not available."
'Nuts' The thought echoed through Whitaker's mind as he rechecked straps and buckles before turning to the ambulance medics. "Damien's is closest. Let's get him in and get ready to go. Skull and rib fractures. Probably a belly bleed too. No radial pulse, weak carotid. GCS 11. I'm gonna come along and take this. You mind?" A nod from the ambulance crew answered that one quickly as they moved to get the fox somewhere that he could be helped.
Thuds and clatter filled the cool air as the stretcher was lifted and slid into the ambulance, the latch locking with a satisfying click, quickly followed by three pairs of boots and the heavy bodies in them clambering in with it. The back of the truck was once again a flurry of carefully choreographed chaos. IVs were started, and saline bags hung. Clothing was cut away, and every inch of the vulpine's body was inspected by sight and touch as another medic started shaving patches of the fox's chest and attaching electrodes.
Whitaker frowned as he pulled the stethoscope from the fox's arm as the blood pressure cuff released. "Can't hear anything. Gotta try palp." Fingers searched out the fox's pulse at the inside of his elbow. Just enough of one thudded under his fingers that when Whitaker inflated the cuff again, he could feel the sudden stop of it as he pumped and deflated the air bladder. "86/palp. Keep it wide open." He looked over to the medic at the head who was trying to insert a tongue restraint onto the fox's muzzle. "I'm gonna give them a call. Let's get going. Hot."
The wolf pulled the radio handset, glancing quickly at the face to make sure he was on the right channel. "St Damien, St. Damian, City Medic 12 en route with a trauma alert. Ten minutes out with a Status 2, approximately 20-year-old male."
"Go ahead City 12," The radio crackled back as the hospital answered.
"Saints, we're 10 minutes out with an approximately 20-year-old vulpine male involved in a single vehicle rollover. Unknown time since incident. Crepitus all around skull, pain and crepitus on right ribs, and tenderness and rigidity on the upper left abdomen. Breathing 30 per minute, pulse 120 and pressure 86 over palp. 16 Gauge right AC running saline wide open. On high flow oxygen via mask. Breath sounds unremarkable on left, diminished on right. Oxygenation 92%. GCS 11, 2 verbal, 6 physical, 3 responsiveness. Any questions or instructions?"
"No questions or instructions, City 12. Trauma one on arrival."
"Medic 12 clear. Trauma one."
"Another night, another belly pain, and bunches of coughs" Dr. Tess Williams growled under her breath. "This is why they make urgent cares." The wolfess bared her teeth and growled to herself as she finished punching the next set of orders into the computer. The printer started screeching beside her as it started printing the labels as the wolfess rubbed her temples and turned toward the cheetah coming out of one of the rooms.
"Janice, could you draw blood counts from 3 and 7. Labels in the queue for you." Janice nodded as she finished wheeling the EKG machine back to the side of the island.
"No problem." The cheetah responded as she stifled a yawn. "At least it's a nice, quiet night." Her tail swished behind her as she grabbed the blood draw basket and labels.
Tess' eyes stared daggers into the cheetah's retreating ass. She started to open her mouth before the EMS radio squawked.
"St Damien, St. Damian, City Medic 12 en route with a trauma alert. Ten minutes out with a Status 2, approximately 20-year-old male." One of the few phrases that was guaranteed to perk ears up in the ED consisted of those two words. Trauma alert.
'Dammit Janice.' Dr. Williams bit back her first thought as she walked over to the radio, picking up the handset from its cradle as she grabbed the pad and pen next to the cradle. "Go ahead, City 12."
Her pen scritched and scratched along the paper, shorthand and abbreviations covering it as her mind started to go through its paces as a paw landed on her shoulder. "Maria's clearing Trauma 1 now." The wolfess nodded curtly at the black furred bear that had whispered it into her ear.
"No questions or instructions, City 12. Trauma One on arrival." Stifling an irritated growl, the wolfess turned back toward the bear. "Tim, get me a trauma pack of vulpine O Negative to start. Hang a thousand bag of saline and bring the fox box to Trauma 1."
"Got it, doc." The bear turned, falling back into a habit that, while not routine, he had done more times before than most people would have preferred to think about. From calling for the blood to be brought out of storage and prepped to moving the vulpine medical cart into the trauma room and sliding it into its cubbyhole on the side of the room, pieces started falling into place. Meanwhile, the wolfess had simply moved to pick up the phone, hitting the speed dial to get the switchboard.
"This is Dr. Williams in the ED. I need neurology and surgery paged for a head trauma about 8 minutes out. Standard group. Thanks." Short, curt statements were the order of the hour as she saw the nursing staff starting to cluster around the trauma room, working like the team they should have been. She skimmed her memory of the handful of other patients scattered around the ED. A quick walk around the rooms and a couple pointed questions satisfied her that she could focus on the incoming trauma.
"Janice." The wolfess caught the cheetah as she was placing the blood samples in the pneumatics to send to the lab. "Stay out here, keep an eye on the folks we have now. Nothing major except 3's lab results. Billy's coming over from fast track. Dr. Miller's over there too. If I can't get you an answer, get him."
"Got it." The cheetah answered almost sheepishly. "CT and radiology on the way?"
"Not yet. Tell CT that we may be sending them an emergent soon. Get a portable X-Ray here too."
"Got it, ma'am." Tess just smirked and shook her head as the cheetah turned toward the computers, getting some of the other needed cogs in this macabre dance moving. The wolfess could hear the siren just starting to bleed through the ER doors as she headed into the trauma room."
"Tim, Airway. Maria, monitor and vitals. Joe, recording to start. He's already got a line." Her mind was racing behind two glinting emerald eyes. From just the radio patch she knew she was going to have someone who was going to be a handful. "Go from there."
Red and blue lights bathed the double doors as the ambulance backed into the bay. It took moments for the doors to slide open and the stretcher to be pulled next to the bed.
Tess' eyes traced up and down the fox as the firefighters and nurses transferred him. She took track of just how bad it was. His eyes were closed, ears flaccid and the part of his face not obscured by the bag mask being rhythmically squeezed by the firefighter at the fox's head looking almost a bit misshapen. The body didn't move at all as the firefighters and nurses lifted the board bound fox and moved him to the bed. She could see his chest moving with each forced breath as his belly did as well. His legs were bound tightly to the board, his ankles obviously broken and misshapen.
"This is Trevor. Twenty-three years old from his license, rollover accident with spidering of the windshield and damage to driver side A-pillar. Emergent extrication through the roof. Nonverbal but could follow commands on arrival. Crepitus around the skull and ribs and face. Right ankle's fractured. Left pupil's blown, right reactive and unremarkable. Pressure's stayed in the 80's systolic all transport with pulses of 120 or higher. Breathing's gotten progressively worse; been bagging him for the last three minutes or so. Still has a gag reflex so just bagging him. Eight hundred of saline onboard."
Almost no sooner than the fox had been laid on the bed, Tess' gloved paws ran down his body. She could feel the bones moving under her touch as she moved down from his head. The ribs on his right side moved under her paw as she pressed. As she pressed into his belly, he let out a groan, muffled by the mask. She could feel it was hard to press against, not wanting to move under her paw.
"Doc, he's still gagging." Tim pulled the airway he had tried to insert from the fox's muzzle as the fox sputtered softly before placing the mask back on his muzzle and going back to squeezing it.
"Just keep bagging then," Tess responded as she nodded at the medics. "Thanks, guys. We'll take it from here. If you've got the wallet, leave it with registration." Flicking her gaze quickly at the monitor she could see the quick, shuddering beats of his heart as she pulled her scope from her neck. Running fast but normal. "Maria, double lumen line on the right. Check on that trauma pack of blood and start another thousand bag and blood as soon as it gets here." Pressing the stethoscope to the fox's chest, she scowled. Whooshing sounds greeted her ears as she pressed on the left side of the chest, but she heard nothing on the right.
"Joe, get me 25 of etomidate, 120 of sux, and the chest tube kit. Tim, speed it up a bit to preoxygenate him." She moved to the cart, pulling the laryngoscope and an endotracheal tool from the cart, snapping the blade on and checking it quickly as her nurse came back into the room and handed two syringes, medications and two flushes to Maria before he hung the two units of blood on the IV stand. As he finished, she handed off a handful of filled blood vials.
"Whenever you're ready, doc. Etomidate, sux, and pair of flushes. I'll get these over to the lab and prep the chest kit as soon as I'm back." He headed out quickly as Maria quickly drew up the first of the two meds and punched the saline flush out of its packaging.
"Push the etomidate and event the monitor for me." The wolfess responded as she moved toward the fox's head. "I got it, Tim," Her paw wrapped around the bag for the mask, squeezing it rhythmically as she waited for the meds to work. "Get the right side ready for a chest tube," She ordered before she turned back to Maria as she heard the doe speak up.
"Etomidate's in."
Tim nodded as he moved to the side and started shaving the side of the fox's chest. "Push ten sux and event, Maria." The wolfess spoke as she bagged the fox while waiting for all of the medications to take effect.
"Sux is in."
"Alright. Maria, get in position for cric pressure in case I need it." She tested the fox's jaw and picked up the laryngoscope. In a smooth motion, she slid the chrome blade into the fox's muzzle, lifting it gently as she tried to see his vocal cords. It felt off. Almost as if the face had moved with the blade. "Get me a bit of pressure, Maria." Her face twisted into a near snarl as she repositioned her head just a little bit. "There we go."
The tube slid into the fox's throat, slipping between the cords before the wolfess inflated the tube's cuffs.
"There we go. Maria, grab the BVM and start bagging him. I've gotta check lung sounds." She pulled the stethoscope from hanging from her neck and slid it back into her ears. She pressed the bell onto the fox's chest and listened to the breaths being pushed into his lungs through the tube through his airway. "Good on the left..." She tilted her head a little and grimaced. "Something on the right but it's not normal."
"Blood's in the lab," Joe called as he came back into the room.
Tess took a quick breath as she heard that as she hung the stethoscope back around her neck. "Grab the chest tube kit from the box and set it up," She barked at Joe before she turned to Tim and his handiwork. "Looks good, Tim. Bolus 60 mils of Ketamine and start a pump for 150 mils per hour. You can change out ambulance's bag with it. Then start the blood. I'm going to gown up. Joe, gown up once the tray's out."
"Got it, doc." Tim moved toward the head of the bed, setting the pump up to keep the fox sedated. Tess stepped to the door, catching Janice's eyes.
"Check on X-Ray for me and tell CT we'll be on the way in five." She waited just for the moment that it took for the cheetah to nod and turned toward one of the cabinets near the door to the trauma bay and pulled out one of the clean gowns out and started pulling it on. "I hate these things," She growled under her breath as she slid her arms into the gown's before she pulled the hood over her head and affixed the strap behind her head.
"Blood's running, Doc. So's the Ketamine." Tim called as he moved toward her and tied the straps behind both Tess and Joe who had just finished gowning up himself. "I've got the wrap." He wrapped his gloved paw around the plastic that covered the front of the gowns, keeping them as sterile as could be, and pulled them off.
"Get him on the vent, Tim. Let's get this done, Joe." Tess' muffled voice echoed out of the suit as she looked over the site, running her fingers down the fox's ribs and finding her landmarks. "There we go. Hand me the scalpel, Joe. Then get the retractors."
"Got it. Scalpel." His reply was just as muffled as Tess' was as he handed the bladed tool to her gloved paw. Taking the gleaming stainless retractors in his left hand, he watched as she sliced into the fox's side, even more blood staining the snowy fur as she sliced into his flesh.
"There we go. Let's get the skin out of the way."
"Got it."
"There we go," The wolfess smiled behind the mask as she grasped the clamped tube and slid the free end into the fox's chest. Releasing the clamp, she could see crimson blood flowing down the tube and into the collection container. "Get me the tube holder, Tim." As she turned the suction on with her free hand, she saw the blood and air continuing to run down the tube before moving her hand to grab the offered piece of equipment. Sliding the clamp around the tube, she pressed the base of the tool against the fox's side before she stepped back.
"K. Get the Portable in here to get head, chest, and ankle. They'll confirm the tube placement and tell us just what level of trouble he's in." She took a quick glance at the monitor and let out a soft breath as she saw the oxygenation improving. She exercised her neck as she stepped back, pulling the hood from her head and letting it fall onto the front of the smock. As the two gowned wolves got at least a little less uncomfortable, the portable X-ray machine was rolled beside the bed. "Lift him up a bit so we can get these plates under him. Once you're done, I'm going to check lung sounds."
"There we go. Much better lung sounds." It had only taken a moment to get the X-ray plates under the board and get another round of breath sounds from the fox's chest. "Let's get back and we'll start to CT as soon as they've got the plates." She shook her head as she pulled the gown off, tossing it into the laundry bin as Joe followed suit.
Beeeeeep
"Got the last one. We'll get them up as soon as we can." The techs packed the machine up as the nurses lifted the board the fox was tied to and pulled the frames out.
"Great. Let's pack him up and get to CT. Maria, move the vent over. Tim, Hook the monitor on the rail and go." Tess was barking out orders rapid fire, in her element as her eyes scanned the gurney and all the attached tubes and wires. The blood, IV bags and meds and pump were all attached to the IV pole. Monitor on board. "Take him down to CT. They should be waiting for you, head, chest, and abdomen."
The sound of rolling wheels trailed off into the winding, serpentine corridors of the hospital as the group made their way through to the CT lab. As the doors swung shut, Tess pulled her gown off, tossing it into the dirty linens bin before her gloves were flung likewise into the trash.
"Janice, how are we?" The wolfess asked as she shook her head on her way back to the center desk, giving herself just a moment to let her mind slow down and the adrenaline to slow down.
"No fires. Blood is back from 3 and 7. Had Dr. Miller take a look at that EKG; looked normal sinus to me and he agreed. Waiting on the labs but he was thinking acid reflux." She shrugged as she dropped the chart back into its slot on the wall. "How's he?"
"Hasn't died yet but he's gotta go up to the OR. At best he's gonna spend more time in the OR than some of the nurses. At worst death from the head injury." She sighed as she shrugged. "But he's a damn sight better than he was before."
"Dr. Williams?" Another voice echoed through the ED and sent Tess' ears bolt upright and swiveling toward the hallway door before she had even had a moment to think about shifting patients. Tess stepped back and turned toward the voice, unconsciously trying to make sure her professional face was on. "Dr. Marshall, Neuro. I got a trauma page. Dr. Farrox is upstairs. "
Tess dropped her eyes to meet the badger's as she took a short breath. "Head and facial trauma. Spidered the windshield. GCS of 8 at most generous. Blown left pupil. He just went off to CT. Head, chest, abdomen ordered."
"Anything known with extremities?"
"Fire said he could follow commands on scene. By the time he got here, he was pain responsive but not following commands. Withdrew from pain on both arms and legs. We had to-" Tess' answer was interrupted by the ringing of the phone on the desk.
"Emergency." Janice's voice answered as she picked up the phone. He was silent for a beat before she responded. "She's right here. Neuro too...Alright. I'll tell them." The clatter of the phone was punctuated with her sigh "That was radiology. They're finished and will be over with him. Radiologist wants to talk to you both."
"That's not a good sign." Tess groused as she rubbed her temples before she continued her previous train of thought. "We had to RSI and tube him so couldn't do much more. Chest tube and probably abdominal bleeding as well. We'll find out in a minute."
Marshall ran his paw across his head for just a moment, massaging his brow. "You've got enough. We'll see what the scans show, but Dr. Farrox and the OR nurses should be prepping the room. Let me check on that. If our guy's got a belly bleed, it's his ballgame first. " With that, he walked to the phone, dialing the switchboard up to make sure that the gears were all turning as they should be.
The clatter of the gurney grew louder as the patient was brought back, followed closely by the radiologist. As he was wheeled in, her eyes flashed across his body. His chest was still rising and falling, and the monitor showed his heart galloping along. She frowned slightly as she saw the deflated IV bags.
"Put him back in 1. Maria, Change out the thousand bag and blood. Tim, check in on your rooms for me. I'll be around as soon as he's leaving." Tess barked out. "What did you see?"
"He's got a pretty bad skull fracture and significant brain bleed right above the left eye. Still has free blood in the chest but lungs are both reexpanded. Free blood in the abdomen as well. A lot more than the chest. Need a little more time to look at the spine but it looks like possible fracture at C5."
"Dr. Williams," Dr. Marshall spoke from beside her. "The OR has been prepped. Dr. Farrox is scrubbing now. " Tess let out a breath as he finished as Dr. Marshall turned to the computer that the radiologist had pulled the scans up on. "Ouch. I'm gonna check with the trauma center on that while he starts. I can relieve some of the swelling but I think he's on the line of our capabilities. I'd rather he fly but regardless of whether I relieve the pressure here or not, he needs to be transferred." He grimaced as he saw the black splotch that the brain bleed showed on the scan as. "But regardless, if he's still bleeding in the abdomen, Farrox's got to stop that first. He's going to be unstable enough as it is without that to worry about regardless of how this goes."
"Alright." She nodded before turning back to Janice as the other nurses started to spread out around the ER again. "Did the lab get the type and cross finished?"
"Not yet according to here." She tapped quickly at the computer. "But they have packed cells and FFP on the way to the OR according to this."
"Good." Dr. Marshall responded, a grim smile of relief flashing across his face. "I'll take him up. Can you spare a pair of nurses for a minute or two?"
Tess exhaled softly. "Yeah." She led the badger to the trauma room. "He's all yours." She smiled as she turned to Maria. "Maria, take Janice and bring our boy up to OR 3 prep. They'll take him from there."
As the sound of rolling wheels echoed through the hall, Tess rolled her shoulders, trying to relax that one tensed muscle that always was just out enough to annoy her. Striding to the computer, she pulled up one of the labs that had come in while they were dealing with the fox.
"At least I can give someone some good news." She smiled as she pulled the file from the wall rack as she headed toward room 3.
"Good afternoon again, Mr. Winters." She smiled at the greying lion sitting on the bed. "Sorry for the delay, but have some good news for you. EKG is normal and cardiac enzymes were normal. Flare up of your reflux I think. Maybe go a little easier on the hot sauce next time."
She smiled as he cracked a small grin at that. "Was what I was hoping. Finally died down while I was waiting."
"Great. As always, touch base with your general practitioner and he can see whether you need to modify your prescription. I'll have someone go over your discharge instructions with you in a few minutes and you can head on home."
She smiled as he thanked her before heading back toward the island. As she was scratching out her notes for his records she heard the hallway doors opening, her gaze flicking quickly to the door as the pair of nurses returned, heading toward the island. Quickly jumping down to the bottom of the scratch paper, Tess scratched a list out quickly.
"Maria, Check on your patients. I should be over to see 7 in a moment. "Janice, pull up these discharge instructions for Mr. Winters in 3 and go over it with him. Nothing found, probably reflux again. Then go to the supply closet and restock the trauma room and fox box. This should be the major things."
"Ok. Let everyone else catch up; I get it." She smirked as she took the scratch paper.
"That. And because you said the Q word." She turned toward the computer as the hive of rooms continued to buzz. She let herself take a breath and think that she might be able to sneak away from the desk just long enough for a sandwich.
"St Damian. St Damian. City medic one fifteen minutes out with status 3 45-year-old male with breathing difficulty."
"Well, there goes that for a few minutes." She chuckled as she went to the base station. "But that's why it's fun." A wry grin spread across her face as she keyed up the transmitter.
"Go ahead, City one."
I hope folks enjoyed. Again, DO NOT TRY ANY OF THIS AT HOME. Comments, faves, and likes are always appreciated and I see and try and respond to every one. I hope you enjoy the rest of my repertoire as well.