Surgical Tandem
Posted on 23 Jul 2023 @ 7:38am by Lieutenant JG Hannah Wagner & Commander Anson Corduke MD
Edited on on 29 Jul 2023 @ 2:48am
Mission:
M3 - Into the Deep
Location: USS Pathfinder - Sick Bay
Timeline: M3 D09 - 1009HRS
1241 words - 2.5 OF Standard Post Measure
The wounds of Major Finn weren't particularly life-threatening, but they were extensive and would become a problem if not handled rapidly. That was what Doctor Corduke had done; made sure to move through his extensive injuries starting with the most compromising and working his way through. Thankfully, he had the help of more than a few Nurses and Petty Officer Mamello, who did just as well managing the medical work as he did settling the Major. Clearly, it was helpful to have a friendly face around for this as the Major was more than a little stubborn, insisting that his Marines get Duke's attention first.
"Alright," Duke said with an exhausted air of finality. "Now we let the body do the healing. As much as I'm sure you'd love to hit the holodeck, Major. You're confined right here until I'm sure all of this," he said, waving at his figure, "Is working as it should. Comprende?" he smirked.
Finn adjusted awkwardly on the bio bed, looking over at Mamello who just folded his arms to look back at him. Declan sighed, "Alright, fine. HQ is right here," he said, pointing to the bed. "Now will you go look at my Marines?"
"Happy to," Duke smiled, about to turn about and do just that.
Having exhausted the store of blood in the small ABO unit of the Pathfinder, Hannah having remembered something from an ancient trauma resuscitation class had instead replicated an artificial heme. Setting the powder into a bag of standard crystalloid, she could replicate the effects of blood without having blood to spare. It wouldn't last, but it would give the ABO unit time to catch up with the demand.
Dr. Wagner was first and foremost a Trauma surgeon and she'd found herself in the thick of it since the teams had returned. Adrenalin coursed through her veins in a quantity that she was peripherally aware would cause a crash of monumental proportions, once she'd exhausted herself...but there wasn't time in the here and now for that.
"Doctor Wagner," Doctor Corduke interrupted gently. "How can I help?" he asked, looking around. With Major Finn stable, the rest of the injuries were relatively minor. This was the only one left that looked like it was of a nearly critical nature.
"I've got it mostly nailed down" she murmerred, her eyes drifting over the patients she'd already treated. "A couple of them need to see Neurosurgery when we get back. This one though, there are a lot of bony injuries, some intrusion from the ribs into the thoracic cavity, and the spine..." Her lips tightened when she spoke of it.
"Ok," Duke nodded, "Ok," he said, taking the tricorder the nurse assisting Wagner offered him so she could continue on what she was coding and so he could see what he was dealing with. "What do you say we take care of those ribs first. Clear up any potential dangers for breathing, or cardiac issues, and do the spine last. He won't need to actually move until then," he offered. The facilities here were small but modern, though he would have preferred to have had everyone on the Theseus and had Wagner as an extra hand not the other way around. But that was more pride and comfort than assistance. He was more than capable of handling all of this in this situation.
"You stabilize the flail segment on the left. " Hannah said as she focused on the right. The tracheal deviation she could see towards the left made her more concerned about the right lung.
"On it, boss," Duke nodded, turning his attention that way. In situations like these, best to just get on it and only break it down or slow it down if something was wrong.
"Thoracotomy tray" She was gratified to see that her nurse had already prepared it, and simply swept the cover from the sterile field so she could use it. Counting down the ribs to the 4th, She made a tiny incision with the laser scalpel on the tray and pressed into the incision. There was a pop and a loud hiss of air that brought a nod of satisfaction from the surgeon. Blue eyes flicked to the readout of his vitals and she was gratified to see his heart-rate immediately drop 20 bpm. Muttering something about small favors, she slid a one way valve on the end of the short tube, and used the same incision to Insert a scope so she could repair the lung tissue itself, without further trauma.
Corduke's side of the equation was much less dramatic than Wagner's, but that didn't make it any less important. She could do her side picture perfect, but if he didn't do this one it was going to be for nought. He made the necessary incisions one at a time, gently pressing the ribs back into place with a dull thunk of bone falling into place. It reminded him of days as a resident, seeing the ways that simple ship-based tasks could mangle a person. He'd debated giving up on medicine before he finally managed to get his stomach settled about the gore. Now, it was as normal as breathing. Maybe even a little bit satisfying when he snapped something into place like that.
He made sure that rib was where it needed to be and moved on to the next, using the clunky, Starfleet scalpel and wishing he'd had the sense to pack the Pahkwa-thanh scalpel he'd worked out of Doctor Pembroke. The device wasn't something Starfleet Medical had their hands on, but somehow Hamish had managed to get his hands on two. He'd given it up reluctantly, but there hadn't been a day that had gone by that he'd needed such a tool that he wasn't immensely glad he'd had the sense to convince Hamish to give one up.
"How much volume have we given him?" Hannah asked quietly, noticing the pooling of fluid in the cavity she'd just evacuated of air. The lung tissue was knitting together beautifully and starting to expand into the cleared space. She pulled back the scope, but left the drain.
"2 units of blood, one of plasma and 2 liters of crystalloid." came the answer from the nurse.
"Best slow down a bit. " Her voice was soft enough that it was clear she was talking more to herself. "Drop the infusion rate to 125 cc per hour. Prep some platelets just in case though."
"Rhythm's still holding. Oxygenation level is rising," Corduke outlined as he read through the readings on the display. His side was all but finished. One last rib to set and then a round of regeneration to make sure there were no further complications. Making sure this kid could breathe on his own, without pain was a huge gain.
"Lovely. I've got his lung reinflated over here, and the bleeding mostly stopped. He's third spacing a bit, but that will resolve itself. Let's turn him prone with a force field stabilizer".
Corduke made a few last minute adjustments and took one more quick tricorder scan of his work and then stepped back, "Alright. Let's move him."
"Good timing. Is my mag bath ready?"
Duke turned around to see the Nurse standing there and she nodded in affirmation. "We're all good, Doctor. Ready when you are," he said.
"Let's get it going then. We still have quite a bit of work to do."
