The Flames of Medicine

3

The once quiet emergency room burst with energy. Doctors were called down even if they weren't trauma due to the magnitude of casualties that were pouring in via ambulances. Ambulances came and went dropping off patients and leaving to pick up  more.

Calum's POV: 

"Lets set up triage over on ER North. We'll keep the passage way clear and ready for more incoming trauma."

"Got it, I'll start to redirect" Ash said grabbing his walkie talkie. "I'm on channel 4" 

"Thanks Ash."

"Cal I got a black tag over here. Want to start setting Black tag ward over ER South?" Micheal said as he replaced his stethoscope back to around his neck and changed gloves.

"Let's do ER West. Closest to the morgue for when they start to transport them downstairs." 

"I'll start redirecting the 2 tags we have so far and set up for more. What channel we on?" Mike grabbed more colored tags and started to head out. 

"Thanks Mike. Ash, you and me are channel 4." 

Calum adjusted his stethoscope one more time around his neck and and inhaled as he prepared to speak loudly.

"Alright everyone listen up!" 

The commotion filled room started quiet down, except for the essential needed movements. 

"The ER is filling up, and we need to post protocol. Trauma triage will be set up with Dr. Irwin over in North bay. Anyone that is tagged Red and Yellow are for immediate care over at North. Green and White will be labeled and will wait here in lobby until we have open rooms available for their care. Black tags will be set up with Dr. Clifford over in West bay. Follow their instructions for set departments. Specialists, wear your badges and prioritize what you see fit, but don't make us work overtime either. Leaders are in channel 4, all others channel 5. Only intercept 4 if highly needed. For incoming traumas perform preliminary inspections, tag accordingly, and don't forget to prioritize and maintain communications. Any questions?"

Everyone nodded and set their walkie talkies to their channel.

"alright. Lets go!"

The emergency room broke into action one more time with everyone going into their respective positions and accepting incoming ambulances. 

Calum, Ashton and Michael set fixed their trauma gear on their coat and pants as they walked towards the ambulance bay to receive the incoming patients.

"Trauma patient.Female, estimated 15 -16 years of age,  Burned on site. Possible subdural hematoma, body estimated 60%-70% burn range, oxygen range low. Found unconscious by Lieutenant Hemmings. The lieutenant asked for patient to be handed off to ER Team 2 on site" the paramedic said as they prepared the girl to get her off the ambulance. 

"yeah that's us. We got her." 

Ashton POV: 

Orders were being given left and right. How could a peaceful night be transformed into something so dark? Something filled with so much death and blood? 

"I need blood bank. Let's get her on some O neg stat" 

The nurse agreed and ran out to get some. We continued to evaluate her condition, granted she was worsening by the minute.

"I've got uneven heart beats. Need a cardio-ultrasound set up stat" Calum said as he started to listen for any other complications. 

"Possible pneumothorax. Need a CT scan stat" Michael said as he reached for the catheter to help relief her difficulty breathing. "This leg needs to be set before her femur sustains more instability and causes more damage"

"She's got a Subdural Hematoma. Her cranial bleeding isn't minimizing. I need to get her into the OR stat if we don't want further brain damage."

"Her heart is unstable she won't sustain much of the surgery in this state Ash" Calum said while analyzing her ultrasound results.

Michael spoke up next with  worse news. "Her pathophysiology is a high level. She's got 65%  of her body burned up. You take her into the OR now she won't make it through 2 hours." 

"She's got an SDH. The longer I wait the more nerve and cranial damage she'll accumulate. Not including cerebral damage and possible paralyses."

"If we can get her stable enough to take anesthesia without the risk of blood intoxication then she'll be strong enough for SDH removal for tonight" Calum said as he started to check her heart again. 

Michael POV: 

"Leg is splinted and back in place. As long as it's maintained drained I can work on it tomorrow if she's strong enough to withstand the surgery after yours." I said as I finished placing temporary staples on her leg to stop the bleeding.

"Oxygen level is rising. Heart palpitations are normalizing. Cranial pressure is growing. I need a decision now or I need I'm going to have maneuver some burr holes to relief the pressure before she's left with no brain activity and no locomotive senses" Ash said as he analyzed her nerve senses. 

Her movement was still in tact. Slow and blurry but still there. But he was definitely losing time in being able to retain the movement. 

"Calum?" I said looking over at the cardio surgeon. 

Calum POV:

If her heart isn't normalizing then there is no point in operating on her. She simply won't make it. There would be no point in even trying to rush her down and try to save her life. She a John Doe, she was found unconscious and we've had no stimulation activity from her what so ever since she got here. 

"Her heart rate is irregular. I'll have to monitor it throughout. If the need and complication arises, I'll have to place her on bypass and manually keep her heart pumping until you can remove the hematoma fully." 

Ashton POV: 

"works for me" I said as I started to place her breathing equipment on the designated area in the bed prepping to roll her.

I turned to look to the nurses. "Prep OR 2. We're coming in hot with an SDH removal. Secondary prep for a cardio bypass. stat" 

Everyone was now removing and replacing with transportable tubing for surgery and removing the last of her clothes and being replaced with the surgical gown. 

"Alright people, let's move"