labs he’d requested. She handed them to the runner and then turnedback to her patient. The woman’s name was Elaine Sansone, and the way she moaned in pain on the gurney made Alyssa privately agree with Jadon’s assessment. Elanie’s abdomen was hard and painful to the touch.
“I need a CT scan of her belly stat. Where the heck is Trauma Surgery?”
“I’m here,” Leila Ross said, entering the trauma bay. She was a petite woman with exotic Oriental features and beautiful straight long black hair. “What do you have?”
Alyssa continued checking Elaine’s vital signs, not entirely surprised when her blood pressure dropped dramatically, confirming Jadon’s assessment of bleeding into her belly. “Blood pressure is down to ninety systolic. Do you want me to give more fluid?” she asked.
Jadon nodded. “Give a liter bolus of normal saline. Leila? What do you want to do?”
“A CT scan would help, but if her pressure is that low, I think it’s better if we simply take her up to the OR. I can explore her belly up there.”
“Alyssa?” Jadon glanced at her. “Get Elaine transferred up to the OR.”
“What about the other patient?” The young twenty-one-year-old, by the name of Curt Neilson, had suffered multiple fractures, especially in his forearms and his right leg. His injuries weren’t as critical, so she’d allowed Maureen to handle his care.
“I’m sending him for a slew of radiology films. The orthosurgeon is on his way in. There isn’t much more we can do other than manage his pain.”
Alyssa nodded and began to connect Elaine to theportable monitor so she could transport her to the OR. Leila jumped in to assist and between the two of them they wheeled Elaine up to the OR suites. When the OR nurse took over, Alyssa returned to the ED to help Maureen.
It took a while to get Curt’s X-rays but just as they finished and returned to the trauma bay, he lost his blood pressure, too. But on the monitor his heart rate still looked as if it was doing all right.
“Check his pulse,” Alyssa said sharply.
Maureen put her fingers on his carotid artery, her eyes wide. “I don’t feel anything.”
Alyssa muttered a curse under her breath and double-checked for herself, although she suspected he was in PEA. “Start CPR,” she told Maureen. Raising her voice, she called, “Jadon? We need your help over here.”
Jadon rushed over and immediately knew what was going on. “His last set of labs were fine, right?” he asked.
Alyssa nodded. “He does have cracked ribs. Do you think he has a tension pneumothorax?”
“Stop CPR.” Jadon picked up an eighteen-gauge needle and inserted it in Curt’s fourth and fifth intercostal space. Within moments his pulse returned.
Maureen’s eyes were wide. “Wow. It worked. It really worked.”
“Yes, it did,” Alyssa said in relief. A tension pneumothorax was life-threatening, yet also relatively simple to treat, once you had the correct diagnosis. A glance at the clock told her the day shift would be coming in soon. Thank heavens.
“I love this job,” Maureen said reverently.
Alyssa had to laugh. Normally, she loved it, too.Most of the time. She’d love it tonight if she weren’t so darned tired.
They waited a long time for Curt to be accepted as an ICU admission. Once she and Maureen wheeled him upstairs and handed over his care to the ICU team, they were pretty much free to go.
Alyssa punched out at the time clock, and then headed into the staff lounge for a few moments. Whoever had hung the Christmas decorations must have gotten interrupted halfway through. There was red garland strung along the ceiling, but an artificial tree stood in the corner, bare of any ornaments. If she had the energy she’d finish the decorations herself.
Her feet ached terribly, so she plopped in a chair and lifted them up on the table. The soreness in her legs eased and she leaned her head back with a sigh and closed her eyes. She longed to rest, for just a
“I need a CT scan of her belly stat. Where the heck is Trauma Surgery?”
“I’m here,” Leila Ross said, entering the trauma bay. She was a petite woman with exotic Oriental features and beautiful straight long black hair. “What do you have?”
Alyssa continued checking Elaine’s vital signs, not entirely surprised when her blood pressure dropped dramatically, confirming Jadon’s assessment of bleeding into her belly. “Blood pressure is down to ninety systolic. Do you want me to give more fluid?” she asked.
Jadon nodded. “Give a liter bolus of normal saline. Leila? What do you want to do?”
“A CT scan would help, but if her pressure is that low, I think it’s better if we simply take her up to the OR. I can explore her belly up there.”
“Alyssa?” Jadon glanced at her. “Get Elaine transferred up to the OR.”
“What about the other patient?” The young twenty-one-year-old, by the name of Curt Neilson, had suffered multiple fractures, especially in his forearms and his right leg. His injuries weren’t as critical, so she’d allowed Maureen to handle his care.
“I’m sending him for a slew of radiology films. The orthosurgeon is on his way in. There isn’t much more we can do other than manage his pain.”
Alyssa nodded and began to connect Elaine to theportable monitor so she could transport her to the OR. Leila jumped in to assist and between the two of them they wheeled Elaine up to the OR suites. When the OR nurse took over, Alyssa returned to the ED to help Maureen.
It took a while to get Curt’s X-rays but just as they finished and returned to the trauma bay, he lost his blood pressure, too. But on the monitor his heart rate still looked as if it was doing all right.
“Check his pulse,” Alyssa said sharply.
Maureen put her fingers on his carotid artery, her eyes wide. “I don’t feel anything.”
Alyssa muttered a curse under her breath and double-checked for herself, although she suspected he was in PEA. “Start CPR,” she told Maureen. Raising her voice, she called, “Jadon? We need your help over here.”
Jadon rushed over and immediately knew what was going on. “His last set of labs were fine, right?” he asked.
Alyssa nodded. “He does have cracked ribs. Do you think he has a tension pneumothorax?”
“Stop CPR.” Jadon picked up an eighteen-gauge needle and inserted it in Curt’s fourth and fifth intercostal space. Within moments his pulse returned.
Maureen’s eyes were wide. “Wow. It worked. It really worked.”
“Yes, it did,” Alyssa said in relief. A tension pneumothorax was life-threatening, yet also relatively simple to treat, once you had the correct diagnosis. A glance at the clock told her the day shift would be coming in soon. Thank heavens.
“I love this job,” Maureen said reverently.
Alyssa had to laugh. Normally, she loved it, too.Most of the time. She’d love it tonight if she weren’t so darned tired.
They waited a long time for Curt to be accepted as an ICU admission. Once she and Maureen wheeled him upstairs and handed over his care to the ICU team, they were pretty much free to go.
Alyssa punched out at the time clock, and then headed into the staff lounge for a few moments. Whoever had hung the Christmas decorations must have gotten interrupted halfway through. There was red garland strung along the ceiling, but an artificial tree stood in the corner, bare of any ornaments. If she had the energy she’d finish the decorations herself.
Her feet ached terribly, so she plopped in a chair and lifted them up on the table. The soreness in her legs eased and she leaned her head back with a sigh and closed her eyes. She longed to rest, for just a
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