At ODDS - Chapter 1

CHAPTER 1

EMERGENCY

When the plates were done, they did a wet reading. The only fractures were at the forearms and shin. That on the forearm was relatively simple. The ribs were intact. THere were no traces of bone splinters. And there was no fear of disrupted organs, only torn flesh and muscle tissues.
"Whai is his blood type?" Hay asked as they quicked wheeled the patient into the operating room from the ER.
"A.B." resonded the paramedic.
"Good. Anyone can be a donor then?" Jay was just trying to be positive. In the town, there was no blood bank. And blood was usually taken from the hospital's own reserve. The child's blood type meant that he could receive transfusion from persons other thank his own blood type and that meant less complication.
Since transfusion is not a simple process, doctors had to know the blood type of the individual because not all blood types are compatible with one another and the patient might end up dying if he were given the wrong type of blood during transfusion.
The boy's blood type was AB. It meant that he can receive unlimited amounts of blood from persons with all the other blood types - A, B, and O- without any adverse effects. And for this, Jay was glad. There were no possible complications and the operation would be relatively simple.
They were still tying to reach the head surgeon bu to no avail. Then the decision was made. Jay was to operate. She was tense. Chuck was there to give her moral support. He knew Jay very well. She was a blooming surgeon. Superb with her work and the bulk of the tension was due to the fact that she was operating without the head surgeon's blessing.
Once in the OR, everyone was set to work. First they had to deal with the compound fracture in the shin before they went to work on the fracture in the forearm. By now the boy was under a general anesthetic induced through inhalation. Chuck was monitoring the boy's blood pressure pulse and breathing. Before the introduction of the anesthetic, his pulse and breathing greatly improved. His blood pressure on the other hand was still the same - within normal levels.
When he was stabilized, Chuck gave the go signal for Jay to operate. In this situation, they didn't have any choice. Although Jay was specializing into General Surgery, she wasn't that experienced yet. But everyone in the hospital agreed - she was good. She had saved the life of a girl who was involved in a car crash once. Another time, she was able to see to it that a construction worker would get another chance at life. But all these operations were with the aid and guidance of the head surgeon.
This time she was helplessly alone. Just like the boy on the operating table. She took a deep breath, picked the scalpel from the hand of the nurse and made the incision on the leg. Spurts of blood sprayed on her and few drops landed on her gauze mask. Within a few minutes, the cut became a joyous crimson. Her objective was to make a large enough opening near the bones, manipulate these into place and secure them. She was glad there were no tiny bone splinters. If there were any these may get into the bloodstream and can cause damage to circulatory tissue. She was also to make sure the layers of pierced muscle were put back into their proper position or else there would be a muscle hernia.


She was careful as she was putting the bones into position. Her gloves were slippery due to fresh flow of blood. When she was able to put the tibia and fibula in place, she fixed the layers of muscle and made and made sure these were in their right insertions. Then she prepared to stitch the incision. After which she put a thin layer of gauze over the cut and started to put the cast.
When she was through with the leg, she proceeded to the forearm. As she was finishing off putting the cast Chuck called her attention.


"His breathing and pulse are changing." Then he paused slightly and looked at Jay with an unnamable look of expression. "blood pressure's dropping. His breathing's stopped." Chuck paused again for a short while before he gave the confirmation, "There's no heartbeat!" As Chuck said that, the distinct morose sound of the ECG went flat. The machine registered a flatline. The respirator was at this point no help to the boy's condition.
The Operating Room was plunged into deep panic as they tried to revive the boy using CPR. As Chuck was pushing down on the boy's chest, Jay got the defibrillator ready. When it was prepared, Chuck gave way to her. She put gel n the boy's chest and readied him for shock.
Jay tried to keep calm. She was terrified. She had been through this process before. But everytime it happened, she was tense. Chuck looked at her strenly. They exchanged glances. Holding the terminals, she called in a loud shaky voice, "CLEAR!"
She put the two terminals on the boy's chest and the shock's force lifted the now lifeless body.

At ODDS - Chapter 1

CHAPTER 1

EMERGENCY

"What kind of emergency is this?" She asked the receptionist who answered her call. "It is a riding accident." the receptionist answered. "A fourteen year old boy and his horse fell into a gorge." "Where is the boy now?" But instead of answering, she heard the receptionist mumble something, not to her but to someone else on the other line. After which, the receptionist told her that her colleague, Dr. Ventura would like to speak with her. Dr. Ventura was the head of the hospital's anesthesiology department. She heard a familiar voice. She was sure it was him. "The ambulance will bring him in anytime now." His low baritone informed her. Jay asked, "Chuck, have you called any other doctors?" She just wanted to make sure that there were others there. She hadn't yet been through an emergency without the help she needed. It was not that she doubted Chuck's capabilities, but he was an Anesthesiologist, not a Surgeon.

If worse comes to worse, Jay would have to operate alone. And if she operates, she would do it without the head surgeon’s supervision or go signal. Although she had tried to operate without the head surgeon’s supervision a few times before, this time, she was not given the permission to handle the operation by herself.

“We have tried but as of now the others on the list are either out of town or still at duty in the city hospital.”

This was pathetic, Jay thought. There is indeed a shortage of doctors in the town, and to make matters worse, doctors who were living in the town either left or commute the one hour to the city everyday to work in a bigger, more functional and prominent hospitals there.

Her thoughts ended when she saw the lights of the hospital grounds loom into view. She parked and sprinted at once to the emergency room. Dr. Ventura was at the ER entrance. As she saw him, she called out. “Chuck! Chuck! Where is the child?”

“The ambulance is still on its way.” Chuck looked anxious. “We are also undermanned.”

“This is the problem with small town hospitals like this.” Jay replied, trying hard to abate the air of anxiety.

Within a few minutes, the sound of a siren broke the still country air. Its flashing lights tried hard to battle the severe darkness characteristic of small ranching towns. The nurses and orderlies readied themselves. As the ambulance stopped before the hospital entrance, a rush of persons made themselves busy. The boy was looked so helpless. Hay thought. At this point, the paramedic who came with the ambulance was relaying the condition of the boy to her and Chuck. Shortly afterward, Chuck talked to a woman who came with the ambulance. She was incidentally the boy’s aunt and guardian. Chuck explained to her the conditions and those they were to do an operation at once. He asked for her consent and let an attending nurse get the paperwork ready.

While the attending nurses were fixing the paperwork, they wheeled the boy into the ER. They successfully stopped his bleeding but to their estimate, he had lost at least two pints of blood. They quickly took an x-ray of him to see the extent of damage done.

There were fractures in both his left arm and leg. The once on the forearm was a simple fracture. However, the fracture on the left was compound. The sight of it wasn’t pretty for a part of the bone stuck out. There was also a suspicion of fractured ribs. However, they couldn’t five any conclusion since the plates were not yet ready. If only the fracture on the leg was just as simple as that on the arm, then all they’d have to do is to manipulate the bones into place a put a cast. All these without incising the patient.

The boy was unconscious, his breathing was shallow and his pulse was weak but his blood pressure was normal. He had bruises and cuts almost everywhere. Judging from his looks, the boy was pretty lucky to be alive. He must have fallen into a deep gorge.

to be CONTINUED