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Hawaii Medical - Emergency Management

Posted on 07 Dec 2018 @ 5:24pm by Lieutenant Junior Grade Artemis Ward, M.D. & Captain Akio Tachibana & Lieutenant Amiri Aldana 365, D.V.M., M.D. & Lieutenant Junior Grade Wyndsor Emerson, Ph.D. & Lieutenant Junior Grade Matsius Amur, M.D. & Lieutenant Junior Grade Radun Dran & Yeoman 1st Class Halona Grayson & Hospital Apprentice Quinn McCoy

Mission: Ka Hakaka Maikaʻi - The Good Fight
Location: Main Sickbay
Timeline: 17 Jan 2389

[Triage Area]

The controlled chaos in the triage area continued unabated as new casualties kept arriving. The nurses kept up with the grim work of tagging the new arrivals and keeping those already processed up to date. The litter of colored paper on the floor continued to build up. All the while the medical crew did their best to stem the tide, bolstered by those from other departments who had come to lend a hand.

Despite wearing a gown over her uniform, parts of Wyndsor Emerson’s uniform were still streaked with blood. Sometimes it came from patients she helped move to biobeds or shift into a better position, so she could get a better look and sometimes it was the result of giving crew in shock an embrace meant to provide comfort and, in some cases, literal warmth. Emerson was no surgeon or ER specialist, but she was surprised at how quickly her advanced medical training came back to her when she was faced with literal lives hanging in the balance.

More difficult, however, was pushing away the thoughts that threatened to freeze her in place; thoughts that people would more than likely die today despite their best efforts, maybe even people she would encounter personally or lay eyes on.

Literally shaking her head to restore her focus, she returned her attention to scanning for injuries she knew how to treat. It was a brutal experience trying to avoid faces and focusing only on flesh, but it was also practical. The faster she got to cuts, burns, and broken bones, the faster she could move to the next patient. Even so, she couldn’t resist offering words of comfort to everyone she passed, an occupational hazard she supposed.

Quinn Emery McCoy sang softly as she worked on yet another injured crew member. “O chì, chì mi na mórbheanna (Oh I see, I see the great mountains) O chì, chì mi na córrbheanna (Oh I see, I see the lofty mountains) O chì, chì mi na coireachan (Oh I see, I see the corries) Chì mi na sgoran fo chèo (I see the peaks under the mist).” Her voice was soft and soothing as she did her best to make each person comfortable, even though she knew they had to be in enormous amounts of pain. “Chì mi gun dàil an t-àite ‘s an d’rugadh mi (I see right away the place of my birth).” she took a breath and turned to the next patient.

A petty officer, lying among the other wounded, roared in pain, loud enough to be heard over the din of the triage area. The noncom’s entire left side was singed and bloody, and there were countless tiny slashes in the uniform. Through the cuts shown jagged shards of glass and plastic, hurled into the patient’s flesh by an exploding console. Now the crystalline shrapnel glinted dully under the lights of sickbay, like some sort of macabre decoration.

Quinn walked over wincing at the state of the person before her, the burns were bad enough, the visible numerous puncture wounds from a console explosion evident. “D’nna worry, we will have ye back to rights.” She said as she tried to access the more threatening injuries to the man before her. He looked worse than a mangled apricot hellbeast, but she was certain with the medical care and know how, he would be back to normal again or at least closer than what he did right then.

“AHHHH! Help me doc!” the man rasped, a rivulet of blood running from his mouth. “It hurts too much, I just can’t take it! Give me anything!” his good arm reached out to try and grasp McCoy’s sleeve.

Quinn nodded softly with the numerous injuries, extensive burns the amount of pain he had to be in warranted a dose of painkiller, she ran a scan to make certain he wasn’t allergic to the compounds that made it up and kept her voice gentle as she gave him, 0.33cc’s of Triptacederine, “This will help ye, Ahm sorry ye’r in pain, Ahm gonna clean ye up a bit afore the Doctor tend ye.”

“Thank you.” The petty officer managed between coughs.

Quinn carefully began getting some of the more on-the-surface bits of console innards out of the wounds as gently as she could while being attentive to the wounds and locations. She checked the degree of burns and made notices for the doctor’s attention. “Sorry for addin’ to ye woes, there but the rest will be needin’ a Doctor’s know how.” She said as she got to her feet, carefully with the shrapnel she had removed from him.

Quinn dumped the bits into the hazard waste container and headed for the supply cart to get a blanket for him before she moved on to the next patient.

Elsewhere, a volunteer dressed in the purple of the diplomatic corps knelt down next a patient that had grown deathly pale. His eyes grew wide as he checked for a pulse, it was very faint, hardly there at all. The patient’s skin was ice cold as well. He searched, but he couldn’t find a wound, or any other outward sign of trauma, and yet the patient was dying. There was nothing in his basic first aid kit that could help, even if there were, he lacked the training to use it. As he peeled off the sticker, changing the patient’s tag to red, he called out. “I need some help over here, please!”

Getting to his knees as Matsius looked at the patient and checked his pulse, the man looked pale and it was low “He got a blow to the chest, heart damage most likely. Heart pulse is faint, skin is pale and cold…” Matsius grabs a injector and press some fluid into it as he injects it into the patient neck and grabs a medical stabilizer “Hold this above the heart and keep it there, the man will get better then” He said; with that Matsius stood up and looked around for the next one.

“NURSE!” Two assistants called out, carrying an unconscious blue-uniformed crewman between them. The new arrival had been rescued from a hull breach, and a thin film of frost still clung to their hair and eyebrows. The patient hung, limp and motionless, in the assistants’ arms.

Dr. Ward rushed over, examining the patient with a critical eye. “Where did you retrieve this patient from?” he asked.

“From the hull breach on deck 17” one of the assistants explained breathlessly. “Life signs are flagging.”

“Alright bring her through to the treatment area.” Dr. Ward directed, setting off in the direction of the doors.

[Treatment Area]

The treatment area rang with shouts and screams, as well as the unnatural electronic noises of the medical equipment. Amidst the noise, medical staff milled around the space, clustering around patients, and running to fetch medicines and equipment. It all played out like a precise, methodical dance.

This was starting to turn into a long day. The Chief started in on the next patient. With as crowded as sickbay was, Aldana began to wonder if anyone was left to staff the bowls of the ship. Still with the damage the ship was sustaining, and the invading Gorn running amuck Amiri’s thoughts couldn’t help but wander to Luuna and her safety. Should s/he bring her to sickbay and direct her and Sombra to wait in hir office where they would have easy, direct access to an escape pod if worse came to worse? All these thoughts flashed through hir mind in less than the blink of an eye. Aldana wiped away a single tear on hir shoulder then shook hir head to clear them. S/he had to continue hir work.

The transporter crew was working at a fever pitch transferring crew around the ship to bypass the boarded areas, and transporting casualties to sickbay. On one side of the room a row of beds sat open waiting for these arrivals. The severest cases, those who would almost certainly die in the time it took them to be brought to sickbay would be transported directly to one of these waiting beds.

[CIC]

=/\= “Hawaii this is PALE HOUND, we have returned with one wounded marine, we are preparing to transport directly to sickbay.” =/\= A message came up to Halona from the returning SAR craft.

Halona gulped she knew Sickbay was already hammered with wounded and the Gorn boarders where not helping matters much in lessening their woes. =/\= Copy Pale Hound, I will notify Sickbay to be ready.=/\=

She took another breath and sent a call to Sickbay,
=/\= Sickbay be advised incoming wounded Marine,=/\= She had no idea how bad things were down there, she just hoped they had enough personnel to deal with one more.

[Treatment Area]

A shimmer appeared over one of the direct-transport beds, growing to match the outline of a humanoid male. In the next moment the energy coalesced into the form of a wounded marine. Captain Santiago had taken a blast from a Gorn disruptor, his body armor had absorbed most of the energy directed at his chest but had finally failed near the side. Just beneath his pectoral, the disruptor blast had punched through, leaving a section of lung and ribcage partially vaporized.

As the beam had continued across his body, it had struck his upper arm in the small gap between two sections of armor, and almost severed the entire limb in the process. The paramedics aboard the transport had strapped the lower limb back in place and attached an auto-tourniquet just below the shoulder to prevent a bleed out. They had also started him on a supply of donor blood, and the blood pouch and other apparatus had transported along with him, they were now attached to the connection points on the biobed.

Doctor Aldana had been monitoring the situation when the call came in, so s/he was already at the marine captain’s bedside when he rematerialized. Hir medical tricorder had simultaneously been updated with his latest readings, so s/he was able to go to work right away. “How many times do I have to tell these medics, ‘protect the airway.’” S/he muttered. “McCoy, this is a good one for you to assist on. Bring a pulmonary-trauma cart and we need to get this patient on an artificial respirator STAT!” S/he continued muttering to hirself, “they stopped the bleeding sure, but he’s got a cavernous hole in his chest.”

Quinn grabbed the trauma cart and came to a halt beside the CMO, “Aye Doctor.” she said as she regarded the mess that used to be a Marine’s chest from beneath uniform and armor. Now it was a big messy hole where it should not be.

“Help me get his tops off, we need clear access to his chest abdomen.” S/he grabbed a pair of scissors and began cutting open his uniform.

Quinn moved to the other side of the Marine Captain and helped the CMO removing the remainder of the Marine Captain’s uniform, vest and what was left of his protective armor. She handed the CMO equipment as was asked.

Aldana had to work quickly to come up with a way to seal Santiago’s lung. Fortunately, recent medicine had borrowed an idea from a product from over a century before used to seal boats. It was a 100% organic film that would eventually dissolve and be harmlessly absorbed into the body, but in and emergency and in the meantime, it would do its job long enough to give them time later to properly heal or replace the lung later when they had more time. “There, now we need to seal and get the air out of his abdominal cavity.”

S/he looked at McCoy expectantly; “what would you do?”

Meanwhile Sombra skirted the edge of the room trying to stay as close to his charge as possible. He ‘island hopped’ going from under one surface to under another, soon he settled down under the biobed ‘Alpha’ was presently at. He sensed something building, s/he might need him soon.

Back up on the biobed the male marine gasped for air, though he could hardly breath. Due to the hole in his chest there was too much pressure on the outside of his lungs, and they could not inflate to bring oxygen to his bloodstream. They would have to work quickly if he were not to suffocate.

Quinn shook her head, “Ahm guessin’ gettin’ the air ou’ of his diaphragm somehow, though how t’ be doin’ tha’ withou’ makin’ it worse?” She shook her head again at a loss.

“I’m not quite sure what you mean crewman.” A nurse mused, coming up alongside the pair. He leaned over and perused the damage to the marine captain, before straightening back up and clearing his throat. “You need some kind of pressure barrier covering the damaged area of his thorax yes?” He asked.

Suddenly an alert sounded, the Marine Captain was running out of time. The team needed to act. Doctor Aldana spoke up, “Computer erect an air-tight restraint field around the patient’s abdominal section only. Decrease the atmosphere inside the forcefield enough to allow him to breath.” In no time at all the computer complied and the Marine Captain gasped, taking his first breath in what seemed like an eternity, but, had only been a few moments. Aldana’s tail began to wag lightly.

Sombra poked his head out, he nuzzled ‘Alpha’, his own tail thumping under the table as he yet again was able to silently do his job from behind the scenes.

Quinn swallowed and waited for further instructions or to be told to get out of way. Her hesitation had caused harm, which was against the oath she was working towards. ‘Do no harm.’

“Well, now the danger is averted, shall we begin with repair?” the nurse commented.

“Uhm… okay… I…I think…” Aldana seemed unfocused. “…we’re in the clear for the moment, let’s catch our breath too. His… uhm… vitals should level out on their own for the moment.”

Sombra came out from under the table. He herded/led ‘Alpha’ to a chair against the wall by the biobed and encouraged hir to use it. Which s/he did. Sombra then began a series of checks on ‘Alpha’ that no one had trained him how to do all those years ago, he just seemed to know they needed to be done. Then without prompting, he skirted the sickbay, being sure to stay out of the way. He located a replicator, and with a slight bounce off his forepaws he nosed the control pad.

This action alerted the computer to pay attention. Sombra continued his self-appointed mission by giving a not-insignificant series of a special pattern of nearly inaudible whimpers, wines, and whistles or squeaks. The computer was able to detect them however; the replicator came to life and in moments what ‘Alpha’ needed appeared. Sombra retrieved it trying to make as little contact with the sterol surface as possible. Finally, he retraced his steps to return to Aldana.

~Is time, take, for you.~

Aldana greeted hir life-line, cupping his head gently. S/he noticed the vile of water with hir pre-dissolved medication. S/he accepted it, cracked it open and downed it, returning the empty container to a pocket on Sombra’s vest. ~“Thanks luv.”~ S/he stood, feeling marginally better and looking significantly improved. “let’s get to work, then after this we’ll each get a short break and a snack.”

---

Two beds down another form shimmered into place, a woman in a yellow uniform and light body armor, “Crewman Matthews,” the nameplate on her vest declared. Another direct hit from a Gorn Disruptor, the blast had punched clean through her armor, leaving a gaping, fist-sized, hole in her abdomen. As she came to rest on the bed, her arm fell down over the side, her rifle slipping from her fingers and clattering to the floor.

Sliding towards the biobed as he taps onto the console and made a full body scan “Nurse I need a few medical officers here right now stat!” He looked at the information as Matsius looked at the crewman and shrugs “The adrenaline shot is going down, we need to seal that…” He mutters grabbing a medical sealer and grabs a plasma knife as he quickly cuts away the armor.

“Yes, doctor” A nurse spoke meanwhile Matsius was busy on the crewman to get some more help.

A man stopped at the bed “Need help doc?” He said as Matsius saw that he was an Ensign and wearing medical clothing “Yes – Rogers was it? – Get that wound sealed. I will check the heart rate and other vital organs” the man nodded and began sealing the wound.

Ensign Rogers worked carefully with the sealer, wounds this large were a challenge even with all the miracles of the 24th century. He began by forming a barrier around the edges of the puncture, to prevent any further blood loss, and then began to work slowly inwards toward the center regenerating a little at a time, in order to try and maintain uniform tissue development as he went.

Slowly the crewman’s blood pressure began to recover, but the rest of her body was showing the classic signs of shock.

Seeing the blood pressure drop as he rolled his eyes “Patient is going into shock!” The nurse quickly elevates the crewman’s feet. Quickly Matsius grabbed an injector and pulls some fluid into it “Get the air mask for CPR right now!” He tests the fluid and sets it up.

The nurse placed the air mask and placed it onto the crewman’s mouth to start the CPR. Matsius notice the alerts on the screen “She is now in shock…” Placing the injector above the heart and waited for the CPR alert to be given, then injects it. The readings get stable again and he nodded to the nurse “Get the airflow normal, pull blanket over her to keep her warm” Matsius orders.



Dr. Ward and the two assistants weaved through the space of the treatment area, making for an open bed. Far from simple, moving across the room entailed dodging medics and nurses as they moved busily around, as well as the in and out flow of patients thorough the treatment area. New patients came in and others were whisked off to recovery.

“Here” Dr. Ward drew up to a free bed and directed the assistants to lay their charge down. With that job completed, they quickly moved off to find their next casualty. Dr. Ward pulled a thermal blanket from the under-bed storage and waved over an apprentice as he threw the blanket over the patient.

Quinn weaved around the busy room to come up on the left of Doctor Ward, she offered up a light smile, “How can Ah help ye Doctor?” She wasn’t sure which equipment he needed as she hadn’t seen the patient’s injuries.

“I need a blood-gas infuser, cortical stimulators, and 20 CCs of Delactovine.” Dr. Ward Directed. “I have a patient here who needs to be treated for vacuum exposure.”

Quinn took a few fast steps and grabbed the requested items and medicine from the supply cart. “Which do ye need first Doctor Ward?”

“First the infuser, we’ll need to ward against any symptoms of decompression, and then be ready with the hypospray on my mark.” Dr. Ward instructed as he cut open the front of the man’s uniform. His brow knit with concern as he looked up at the monitors.

Quinn took the hypospray and stood ready as she listened to Doctor Ward’s instructions and followed his lead on the treatment of the patient.

Dr. Ward placed the infuser over the patient’s heart, attaching the input/output tubes of the high-volume model to the skin above the inferior and superior vena cava, the largest veins in the human body. The device lit up as it powered on and tapped into the blood supply, Dr. Ward brought up the controls on the bed’s interface panel and switched the infuser from “oxygenation mode” to “homeostatic management.” A moment to watch for the first results, and he turned to Quinn. “Now.”

Quinn followed his instructions to the letter and administered the hypospray on his word. She kept ready listening and following his orders and giving each piece of equipment as it was requested.

With such efficient help, the color was returning to the patient’s extremities in short order. They responded well to cortical stimulation, with the drugs bolstering their system, they began to regain consciousness. Dr. Ward flagged down a pair of orderlies to move the patient to recovery and set off again.

 

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