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Sick bay: Order within Chaos

Posted on Wed Feb 27th, 2019 @ 11:38am by Commander Crystal Verrill & Lieutenant Hetara & Lieutenant JG Graham Soccul PhD & Ensign Eska MD

Mission: A Journey to the Stars
Location: Sickbay

Crystal had just finished her checks of engineering, and her next stop was Sickbay, to check on casualty figures. She walked into sickbay looking for someone in Medical Teal. Sickbay was, as expected, packed with patients. She had initially specialised in medicine upon leaving the academy, and decided to lend a hand.

Graham looked at the female officer that walked in, unaware of who it was at this point, greeting them abruptly with “Greetings, were a bit busy at the moment, can I help you with anything?”, Graham carried on treating patients with various different injuries carrying around his tri-corder and medical files.

“Commander Verrill, Executive Officer. Anything I can help with? Is the CMO around?” Crystal asked, looking at the Lieutenant in front of her.

“My apologies Commander! I’m sure we can find you something if you’re able to? I’ve got this patient in bed 3 who needs treatment but I can’t for the life of me get near him... I think he’s suffered a head injury which is making him aggressive when I go near him... would you mind giving him this hyperspray of Rexlin if I hold him down?”, Graham said whilst hurriedly dealing with other patients who are less challenging... he continued “either that or you can deal with bed 2 hours has significant burns, bed 6 who has a broken leg... Chose your fancy Commander”, Graham said with a slight jokingly manner... “As for the CMO, I believe they’re around here somewhere I saw them moments ago...” he finished his sentence, smiling at the Commander.

Crystal nodded, looking around. “Let’s get the sedation done first, then we’ll move onto the rest!” She moved over to the man and prepared the hypospray. “Ready when you are!” She said.

Graham smiled at the Commander, nodding in agreement. “Aye aye, Commander.” He head over to the patient who became increasingly wriggly on the bed, their screams becoming ever more haunting from the obvious pain they were in. He held the arms and chest down as best as he could, waiting for Crystal to administer the hypospray... “Ready when you are...”

Crystal nodded and pushed the hypospray to the mans neck, pushing the activator. The fast acting sedative showed a change within moments. “Ok, I think we’re good to move on.” She said, smiling at the Lieutenant. “Let’s do the burns next and then move onto setting the broken leg.” She moved over to the burns and took out a hypospray of morphenolog, to relieve the pain. She then took out a dermal regenerator to start the healing process of the burns.

“I think you have this one covered Commander, I’ll sort out the ensign with this broken leg and get that sorted whilst you’re working you’re magic here, if that’s ok?”, he said as he walked over to the injured ensign in bed 6. He set up the necessary equipment, gives a hypospray of hydrocortilene and begins documenting whilst undertaking the procedure.

Graham looked over at the door as it opens, greeting the CMO as she entered, “You have a visitor too... Commander Verrill I believe?” He says in a questionative tone.

"Commander," Hetara said, all business in the present MassCal, and looking around to assess the state of patients coming in, even as she addressed the XO. "You don't look injured, and you appear to be assisting, for which I thank you. However, I assume you've come for a casualty report. At present, we have two dead and over sixty injured, though I haven't made an official count since I've been somewhat occupied with keeping the count of 'injured' from adding to the 'dead'."

Crystal nodded. "And I assume we still have injured funneling in." She said, dodging out of the way of a stretcher being bought in with a young ensign. "I'm here to help - just point me to a patient and i'll get to work." She said, looking around at the ever growing crowd of injured. She tapped her commbadge. "Verrill to Bridge - get an engineering team to setup triage facilities in the holodeck. Make it a priority." She said.

"Indeed," Hetara remarked wryly as the stretcher went past. "We appreciate the help. And a second triage site will help alleviate the congestion in here. If possible, it would be useful to keep the Green and Yellow - not urgent and less urgent," she added in case the XO wasn't as familiar with medical jargon, "in the holodeck where they can be treated anyone with basic First Aide. That will let us better focus on the urgent cases here."

Crystal smiled and nodded again. "We can do that. I'll get you the hands you need to move everyone." She tapped her commbadge again. "Verrill to Security - send as many of your teams to sickbay as soon as possible. I need some people moving." Turning back to Hetara, she smiled. "Let's get to work then. I still have my Medical Degree." She said.

"Excellent!" Hetara replied with a smile, already moving toward the next patient in the urgent queue. "Let's put it to good use."

Crystal followed at looked at the next patient. "Right...what have we got then?" She asked the question to no one in particular - but knew that someone would answer.

A low moan came in answer.

"Electrical shock and concussion," Hetara diagnosed. "I'll let you -"

Eska came into sickbay on top of someone, applying pressure to a gaping chest wound. Her uniform top is covered in blood, right along with some of that blood in her hair and down the right side of her face, her combadge was missing. They both where being carried in on a makeshift stretcher by a pair of Security Officers. "'URGERY!" She said gesturing with her head.

"Clear a table!" Hetara yelling orders, as she dashed to come alongside them. "C-P bypass unit and 3 units of whole blood - stat!"

Nurses and medtechs rushed to obey. In fact, even before she drew breathe to command it the trauma team was reacting. Which was as it should be. Surgeons might get the lion's share of the credit, but response was a team effort. It had to be. For something like this, no doctor, no matter how good, could hope to save a life on her own. By they time they were shifting both Eska and the patient to an operating table, a PA was already setting up an intraosseous transfusion to more rapidly replenish the blood supply, but not pushed until the next step was in place.

"Scan complete, Doctor," Specialist Xen reported, bringing up a detailed 3D image of the critical area, right down to every open blood vessel. "Field layout prepared."

Hetara nodded acknowledgment. "We've got him," she told Eska. "Hop off so we can snap up the micro-forcescreens."

Eska slipped off the man, and nearly ended up on her own rump. "'Kay." She said getting out of the way. "Umpting chest in be." She said in Novan.

"We see it," Hetara told her as she signaled for the screens. Carefully tailored micro-forcescreens sprang up, blocking off bleeders and replacing ruptured tissue, much like the ship's emergency forcefields would seal a hull breach. Indeed, the idea was exactly analogous - except that the edges of a ruptured hull were not as soft and prone to shifting at any touch. But there was a metal shard inside the patient, and it had to come out.

After a quick assessment of the display, Hetara signaled the surgical tech. "Push the IO and beam that piece junk out of him!"

The resident tech tapped a console and the section of metal dissolved in yellow light. An instant later, two other medtechs had the surgical support frame secured over the wound. It had been done smoothly, efficiently, like a dance troupe stepping through a well-choreographed routine. But a sheen of blood spread still spread under the patient and dripped from the edge of the table.

"Adjust those screens," Hetara snapped, even as she reached in to - ironically - draw a pool of blood out with a catheter before the built up pressure could impact the patient's lung. "Keep them as tight as you can." There was no need to elaborate on why. Everyone there could see blood volume, systolic pressure, and most worrying, brain oxygen levels. Looking to Eska, she said "Unless you're injured, scrub up and assist. I'm going to need extra hands for this."

Eska bolted out of the room and scrubbed up. Once she was finished she returned to the doctors side to aid in whatever way she could. She still felt the drying blood in her hair, but their was nothing much she could do about it at the moment.

Hetara glanced up, and though it wasn't visible behind her mask, she smiled at Eska's dedication. And her presence. The more hands helping, the better the patient's chances. The 'field expedient compression bandage' of a doctor applying direct pressure was all that gotten him here with any hope at all and even with all the tech here his survival was far from certain. Every additional moment with minimal O2 reaching brain tissue increased the chance of irreversible damage...

She willed the thought away, sealing it in a mental compartment - one of the near infinite row of closed boxes on the shelf of a surgeon's psyche, where the empathy or horror or revulsion or any of a dozen other normal reactions had to go if she was going to be able to reach into another being's guts and put them back together. That was all she could focus on: methodically repairing the damage while others worked in concert to support that work. She tapped the edge of local forcescreen, signaling for it to be dropped or pulled back so she could apply a dermaplaser to exposed tissue. "I'll work on the arterial damage. You patch the lungs," she said to Eska.

Graham walked in to main sick bay and saw what could only be described as a horror movie. He dropped his dermal regenerator and tricorder, hurried his way to scrub up and made his way back to the evidently busy and focused Hetara and Eska. “Anything I can do, Doctors?”, his approach was simple and formal, almost emotionless. “Do you need a hand here or do you want me to focus on the others?” He offered up as a suggestion in case he was not needed here,

As much work as this patient needed, Hetara knew they couldn't tie up three doctors on one case when there were so many others waiting. "Get the next urgent case, Gray," she said. "But set up on the next table in case we need you."

"Sounds like a plan Hetara, I'll...", Graham was interrupted by the sick bay doors opening again with an Ensign being carried through by two security officers. "She was stood next to a conduit when it blew in Engineering. She's looks badly burned" said the unknown Security Officer... "Looks like I'll be grabbing this one," he said to Hetara as he turned to the incoming patient, "Set her on this biobed right here," as Graham started to scan the injuries that the ensign had.

Graham started to press multiple buttons on the biobed to begin scans of the ensign, which showed extensive superficial and partial thickness burns, luckily no full thickness burns. Graham proceeded to activate the bioregenerative field on the bed, and giving a shot of kelotane loaded into a hypospray, quickly changing hyposprays to a pre-loaded Rexlin dosage in for pain. Graham continued to monitor the patient.

"This one should be fine, she's only got first and second degree burns, she's stable otherwise." he voiced over to Hetara, Graham continued as he looked at his triage list to see who his next patient would be, he had got a head injury or someone who had broken their leg... He looked up at Hetara, "You good with me moving on to the next one, this ensign should be fine, just got to wait for the bioregenerative field to do its work, then she can be moved down to the Holodeck for obs and monitoring by the trained personnel down there and then we have the bed free again?" he propositioned the question to his CMO, hoping she would agree...

"Sounds good, Gray," Hetara answered, only briefly glancing up from the patient she was working on. "Have a tech can monitor vital signs on that one, but otherwise in this kind of situation, best practice to get them out of danger and move on to the next one as quickly as possible."

"Sounds good, I'm glad we're on the same page," he delegates the task to a tech "Once the bioregenerative field is done, let me know and I can get someone else on that bed and transfer her down to triage", the Medical Tech nods and starts his work watching over the poorly patient. Graham proceeded on to the next patient who had a head injury, Graham scanned the officer with his tri-corder, it showed that the head injury was minor and was mostly superficial cuts with minor contrecoup injury. Graham collected his anabolic protoplaser, using it to fix the external cuts to the officers head infront of him. Graham loaded up a hypospray of Alkysine to help with the damage to neurological tissue, he again sends the officer down to Holodeck to be monitored and observed by medical techs.

Whilst he had a free moment, he looked up at Hetara before having the Medical Tech interrupt saying "The ensign, the bioregenerative field is complete, sir.", Graham nodded and resumed towards Hetara "How's things? I'm about to send the burns down to triage, and I've just sent a concussion down there for a few hours worth of obs. You managing, or need any assistance?" he asks in a concerned manner making sure his medical staff, both superior and subordinate are well looked after during a stressfull event.

"We're nearly ready to close here, but I'll want him in ICU rather than the holodeck obs," she replied. "Good job on the burn case, by the way. Take a look through the triage line for plasma burns - those need extra attention." Glancing up at Eska, she smiled behind her mask. Based on her record, this was the younger physician's first mass casualty experience, but she'd risen to meet it. "You did well here. I think he'll owe you his life. But you should take 5 now. Hydrate and rinse off it helps. We'll need to start spelling each other soon to be sure there are no mistakes due to exhaustion."

"'es." Eska said heading into the the scrub room. It was there that she collapsed to her knees. The adrenaline that was running through her system finally gave out. She stayed on her knees starting to shake.

"I'll get the Medical Techs ready to move him, I'll get the ICU bed ready and waiting for him," Graham walked over to the ICU compartment of Sick Bay, as he popped his head around he ordered "Get me a ICU bed ready for 1, stat!", his voice resonated with authority and urgency to which a scurrying of medical officers began to work on readying the bed.

Graham went back to his triage PADD, as he looked for any injuries matching that of a Plasma Burn, he found one case which was due to arrive any moment. He looked up at Hetara stating "Would you mind giving me a hand with this one, sounds pretty bad?", he continued whilst reading the PADD, "Plasma burns to face, arms, torso, legs and feet" he rambled, "deep lacerations to face and torso." They're being rushed in by Security as we speak they should be here any..." The doors opened to two security officers bringing in Ensign Roger Detaz, who looked worse than originally stated.

Graham looked at the Ensign, then looked up at Hetara giving a concerning gaze... "I'll get him sedated, on the biobed and start on treating with fluids if you want to start getting those burns under control? Last thing we want is for this guy to go into hypovolaemic shock..." He looked up at Hetara once more, looking for her acknowledgement.

"Yes, good," Hetara said, hurrying over. The burns were serious; concnetrated plasma could char down to the bone. But what worried her most was the burn pattern on his face. "Scan his lungs - if he inhaled plasma we need to push syntho-surfactant now!"

Just as if it had heard Hetara, the biobed began displaying the extent of the injuries, it showed extensive injuries to Ensign Detaz's internal organs including cardiovascular, respiratory and gastrointestinal tracts. The ensign's airway was compromised due to the plasma burns which had quite clearly been inhaled and ingested. Graham looked up at Hetara again, giving the same concerned look as to what to do and began the treatment suggested. He prepared the syntho-surfactant before administering it as per instruction.

Graham suggested, "How about we sedate the patient, take over their own airway by creating some sort of holographic airway and lungs for now whilst his are repaired? Can we do that? Would it be possible? Because the more he inhales this plasma the more damage it will do..."

"Yes." Looking to the other medical staff arriving in response to an obviously urgent case Hetara began issuing orders. "Q'asa get him under. Jackson, set up the heat-lung holographic bypass." Looking to Graham, and making a mental note to speak with him later about taking initiative in directing staff (after all she'd once suddenly found herself acting CMO because her previous CO had died in action), she said "Push the syntho-surfactant. We may have to do organ replacements but the more we save, the better and we need to get him stabilized before we open him up to deal with internal damage."

Graham nodded, “syntho-surfactant already administered, we have him sedated, now we just need to engage the holographic bypass.” He looked up at Jackson who scrambled around in a sense of urgency. “I’ve also got fluids up and running to compensate for the hypovolaemic affect of the burns. He’s got high flow oxygen on him, and...” A ever so faint sound of whirring was heard, the holographic bypass had now been initiated. “And now that’s active, we can start. If you scrub up first Hetara, I’ll join you shortly after, I don’t want to leave this ensign without a doctor at all times.” He firmly recommended.

"Yes. Good," Hetara said approvingly, even as she turned to pass through the sonic sterilizer and don a new set of gloves, flowing through the familiar movements almost as though it were dance.

Regardless of her response, Graham grabbed his medical tri-corder and began to scan the wounds, whilst he set the biobed to scan.

Returning, Hetara 's eyes went immediately to the bioscan readings and the patient himself. "You can scrub in now, Gray. I'm going to increase the sterile field strength here as well. With the burns through the dermis, sepsis is serious”

Graham nodded in agreeance, as he walked off to scrub up. He returned shortly after and began to speak with a muffled sound due to the face mask, “Let’s open him up and see what we’re dealing with fully, see if we can save his lungs or if he needs a transplant”. He picked up the scalpel and began to start a thorocostomy. Upon completion Hetara and Grey saw severe damage to the lungs, Graham looked at Hetara “I think a transplant would be in order”...

"Yes," Hetara replied, frowning. Infection was the greatest post-op danger for burn patients, and even using new lungs replicated from his own DNA some degree of immunosuppression therapy was usually necessary to prevent transplant rejection, so it would be a delicate balance over the next few days between the two risks. Taking her laser scalpel, she excised a small sample of undamaged lung tissue and transferred it to a culture plate. "I'm going to take a skin sample sample too, so we can start culturing grafts. He's going to need them," she remarked as she delicately removed a sample for the autograft.

"Lungs, trachea, and at least a meter of dermis," she told the medtech waiting to take the samples to the medical replicator. As he hurried off, she looked up at Graham. "We can leave the lungs in place while the transplant's being grown. There's a lot of burnt exterior tissue that needs to be debrided before we can begin regeneration. I'll take this side, you take that one, okay?"

“Yeah I got that, Doc’” Graham replied, nodding and smiling at the teamwork being displayed. He begins to start debriding dead and burnt tissue.

Eska got herself under control, and headed to get clean herself up. Then she head back out to get herself busy. She was driving the nurses crazy as she was speaking at high speed Novan.

Absorbed as she was in working on the burn patient, Hetara couldn't help but notice. She had been starting to get a little sense of Novan, but even she could barely make out what Eska was saying. "Doctor Eska," she called, not breaking the rhythm of the debridement. "There are two patients with fractures waiting.. Please, get them into osteo regen."

Graham looked up from his patient, “I’m nearly done here now Hetara, I think... What about you? How you looking over there?”

"'es." Eska simply said heading for the patients.

With a nod to Eska, Hetara finished removing the last of charred dead tissue on her side. "I'm done over here, Gray," she said. "The lung transplant should be ready and then we can lay in dermal grafts and let the bioregenerative field handle the rest. He'll need additional neurological repair, but that and dealing with scarring can be handled later." She looked around the many wounded still waiting for care. "We have a lot of work ahead of us..."

He nodded, sighed and began to clean himself up awaiting for the night doctors to come and relieve them.

Crystal had been watching from a distance, not wanting to get to much in the way of such a delicate procedure. She was happy that the CMO and new ACMO were working well as a team, and had this handled well. With a brief nod to Hetara she headed out of sickbay, and on to her next stop, with the Chief Tactical/Security Officer.

=/\=End=/\=

Commander Crystal Verrill
Executive Officer
USS Endurance

Dr. Hetara
CMO
USS Endurance

Dr. Graham Soccull
ACMO
USS Endurance

Ensign Eska
Medical Officer
USS Endurance


 

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