The surgeon stopped short, her face became serious, as all she could do was shake her head, not wanting to ruin the day for either Danni or herself by saying what they both already knew but chose not to think about.
"Oh, I see," was Diana’s muted reply, "well, I’m glad that you’re with us today."
Garrett agreed and turned to see Danni become pale and nervous looking. Without a warning, the nurse swallowed hard and found herself needing to walk away before the tears sprang forth. "I…left something in the car. I’ll be back." Then she was gone.
She just couldn’t help it. She didn’t want to know what was going to happen. Danni just prayed that she’d be able to live through it.
In a few minutes, the nurse was able to cope once again as the rest of the day drew to a close. It would be a memory-filled time for them both to reminisce about.
Everything was dwindling down to the last in a series of things for the women. First it was their last ride into work together that started off the day, then their last mid morning coffee, and their last slow wait through the express line in the cafeteria for lunch. Then, on their way home from work, it was the last take-out pizza dinner that they’d pick up. Now in the hours slowly ticking by, they waited for their last call out and emergency flight. Each one wanted just once more to remember their time as a team but not really wanting to wish misfortune on anyone.
Just when it looked as if it was over, the pager went off, startling them both from the late night news broadcast that they were watching. Danni jumped up, and ran for the bathroom as Garrett got the message from the pager. "MVA with multiple victims."
The surgeon flipped her cellphone to her ear as she pressed the speed dial to the Command Center. "Trivoli here." She listened for a minute then ended the conversation. "We’re on our way with a ten minute ETA to the helipad."
The ride both by automobile and helicopter was quick and they were soon circling for the descent to the designated landing zone. The fly by over the accident scene showed the severity of the crash. They were able to make out the form of a vehicle in pieces as the impact with the utility pole had split it in two. Off to the other side of the road was another vehicle with its front end smashed and flipped onto its roof.
Danni shook her head in disbelief. "Can you image that?"
"Looks like we’ll have our work cut out for us down there." The surgeon sighed and mentally prepared herself for being the triage person who would decide which patient would be given a chance at life and who would be beyond help. "Cowboy, are there more choppers being sent to this scene?"
"That’s an affirmative, Doc." He looked into the rear compartment. "We doing a load and go?"
"No, I’ll have to triage and take the last one out."
"Gottcha, I’ll park us in the farthest slot." He turned his eyes back to the ground below as he picked out his spot. "I wonder if that was a wedding limo down there. What do you think?"
"No, there’s different colors to the clothing. My guess is that it was Prom Night." The blonde’s face was filled with emotion as she remembered the numerous Proms that she had attended at the hand of her mother. "They were probably having the time of their lives and now look at where they are, just trying to stay alive."
"Get us down there, Cowboy, and we’ll see what we can do." Garrett picked up on the melancholy in Danni’s voice.
The Scene Commander had explained the accident as another result of drunk driving at its best. The car on its roof had been traveling at a high rate of speed and went airborne when it crested the rise of the hill. The Limousine driver saw the hurtling car coming in his direction and stepped on the gas to get out of its way. That’s when he lost control and went broadside into the utility pole.
Garrett surveyed the scene of rescuers as they worked to meet the needs of all the patients. The team first took note of the patients that they could easily access as they made their way to the very open rear half of the limo. None of them had been wearing seatbelts as the array of bodies intertwined one with the other was evident. There were six in all; only two of which had been backboarded and collared as of yet. Danni and Garrett each stopped by one of them and did a quick assessment of their injuries and condition in general. Each one had some broken bones but was stable enough for a quick transport to the hospital without any other medical intervention. Their I.V.’s were checked for infiltration and drip flow and then they moved on to the next in the long line of patients.
Two more helicopters filled the air and made Danni feel a little relief at the thought of getting them all to the care of an awaiting Trauma Team. There was only so much that she and Garrett could do in the field and right now, their resources were stretched to the limit. The nurse met the incoming Flight Crews and directed the patient flow out of the scene as deemed by the surgeon. Within minutes, the two packaged patients were loaded into the helicopters and on their way to definitive care. Danni turned around to find out where Garrett was and headed for her.
The surgeon stood over a young woman who had been closest to the point of impact. The patient’s shallow, gasping breaths were a sure sign of fractured ribs. Garrett’s concern for her breathing and the fact that the impact had already broken bones, made her more worried of the possible spinal involvement, too. It was certain that this patient needed to be flown out next.
The surgeon looked over her shoulder as Danni approached. "This one goes next," she directed the nurse. Garrett watched as her team member nodded in understanding.
The nurse turned her eyes to the heavens and looked for the next helicopter to start its descent. Knowing that it would be a few minutes for it to land, Danni turned her attention back to the patient and monitored her condition.
"GAR!" The cry came out as the nurse lifted her stethoscope from the patient’s chest. "Her pneumothorax is getting bigger by the minute. I think she needs a chest tube fast."
The surgeon’s attention was split now. "Danni, we don’t have that ability out here. Besides," Garrett looked up from the patient that she was getting ready to intubate, "I’m needed here first. You’ll have to needle it and use the tip of a glove for a flutter valve."
"But I’ve never…"
"You’ve watched me do it a couple of times. I’ll talk you through it. You’ll do just fine."
The nurse nodded her head. "Okay, I’ll try."
"You’ll do it." The order was given in no uncertain terms. "Now get an 18 gauge needle and cut off the finger of a glove. Insert the needle down through the tip of the glove."
"Okay, done."
"Now find the fourth intercostal space on the effected side of the chest." The surgeon paused until Danni had found it. "Give me some suction here. You got that tube ready?" She asked the ambulance member that was assisting her in the intubation.
"Did you find it, Danni?"
"Yeah, found it."
"Good, now pass the needle just over top of the rib and insert it into the chest wall at the midline of that side, parallel with the nipple." She picked up the laryngoscope and opened it. "You’ll know that you’re deep enough when you hear the trapped air escaping out of the make shift flutter valve." Inserting the tube into the mouth of the patient that she was working on, she continued to guide her team member. "Once you’ve got it in place, tape it down."
Danni offered up a prayer on both her and the patient’s behalf and did what she was told. "PHSSSSSSSSST!" The rush of air escaped and she breathed a sigh of relief. "Got it, Gar."
"Good, I knew you could do it." The surgeon pulled back the stylet as she held the endotube in place. "Now secure it." She directed to both Danni and her help mate in the intubation. "Give her a minute and she should be breathing easier." Garrett looked over to the nurse and beamed with pride in the woman, then resumed her ministrations to the patient before her.
Danni smiled with confidence at what she had done. It was just one more time that proved how well the surgeon and the nurse worked together.
Now, with their patients handed off to the next two Flight Crews, Garrett and Danni pushed on to the last two remaining teens. Their injuries were not that devastating but the emotional drama that they had been witnesses to was taking its toll. The surgeon assessed their physical conditions while Danni took care of the emotional support that they needed.
It absolutely tore at the young nurse’s heart to see the effect of emotional carnage that the one young man was displaying. His wild-eyed, frenzied look was enough to show that this night would be forever locked in his memory to haunt him when he would least expect it.
Danni sat next to him and held his hand, talking to him and comforting him as only she could do. Healing was not always done with medicine, especially when it came to the emotions of trauma. It took a while, but her soft voice and concern for him and his friends soon soothed the young man enough to allow him to be loaded on the next helicopter and transported to where his friends had been taken.
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