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At twenty-six years old, I've been a nurse for four years. All-in-all, not a bad job, but sometimes the stress gets to be more than I can take. Someone once told me that the medical field has the highest highs and the lowest lows. I've found this to be the case, especially after I became a flight trauma nurse.
As a flight trauma nurse, there is nothing worse than getting a call out an hour before your shift ends because there is no way in hell you're going to get off on time. I guess I knew that when I took the job, but that doesn't make you any less tired when you didn't get enough sleep the day before. When the radio sounded, I knew I wasn't going to sleep for hours....
The rain was pouring, and I realized once again just how much we trusted Scott, our pilot. He had gone to Vietnam right out of medical school, and on one med-evac flight, his chopper pilot had been killed by enemy fire. Scott, who'd never flown a helicopter in his life, managed to crash land the chopper without losing a single life aboard. He returned to the States as a doctor, but he found his way back to his true calling behind the stick of a helicopter.
Scott was well over six feet tall and a tightly muscled two hundred pounds. Though now about fifty years old, were it not for the white streaks in his hair, he could have easily passed for a man in his mid-thirties. Despite how attractive he still looked, I, like the other members of the team, thought of him as a father figure. It was the sense of security that only a father figure provides that kept us from wetting ourselves as he skirted through trees and buildings.
We finally arrived on the scene, and it was a mess. Some sort of sports utility vehicle had been hit almost head-on by a tractor-trailer. I had a sinking feeling that anything in that SUV was too far gone for us to be of any help. The situation was dismal beyond belief. The late summer rains were pouring, and visibility was almost nil. To top things off, a live power line was positioned precariously close to the vehicle. Protocol demands that we wait for fire-and-rescue units to arrive and for the electrical feed to be shut off. I had no problem with that until I heard a soft whimper, "Help...."
I knew my ass was going to be in a sling for this, but I couldn't not help someone if there was a chance to save them. I grabbed the equipment bag from Scott's shoulder and took off for the wreckage as Scott, who was also our medical director, yelled for me to wait for back-up. I reached the front passenger door, which was the source of the distress call. Whoever he was, he was alive, but just barely.
I had to get in there to check on the driver since the cargo trailer debris was blocking my view of him or her entirely from the outside of the vehicle. I told the passenger to close his eyes as I used the equipment bag to break through the rear passenger window. When I did, the power line shifter even closer to the roof. Scott yelled for me to get the hell out of there. I craned my hand to my ear and squinted my eyes as though I were trying to make out what he was saying. Then I ignored him and climbed in the back seat. Needless to say, he then started barking at my through the radio mounted on my right shoulder.
"Are you alright?" I asked the passenger.
"Hard to breathe, and I hurt. Other than that, I'm perfect," he whispered with a smile. Even though blood covered his entire face, the toothy grin (quickly replaced by a painful grimace) was cute and brought a smile to my own face for a moment. "How's Craig?"
I presumed he meant the driver. A piece of steel lodged in his neck had nearly decapitated him. He had died instantly. "Craig wants me to take care of you right now." I didn't want to add to his stress by telling him his friend was far past my meager skills.
"What've we got?" Scott chimed in via the radio, reminding me of his omnipresence.
"The driver is PCS, " I told him. My father was also in Vietnam. PCS is an Air Force term--Permanent Change of Station. I knew Scott would catch the meaning so I wouldn't have to make the morbid announcement in front of the passenger.
"And the passenger?"
As I performed my head-to-toe examination, I responded, "22-23-year-old white male, roughly six foot, 170 pounds. Heart rate 130, respirations 40 breaths per minute, blood pressure 78 systolic. General appearance is well-developed and well-nourished. Head is normocephalic. There's a cut at the hairline, roughly 14 centimeters long, half a centimeter thick, and superficial in depth. Pupils are equal, round, reactive to light and accommodation. Extra-ocular movements are in tact. Ears are normal. Nose has what appears to be a simple fracture at the bridge. Oropharynx is clear. He's diaphoretic and pale...."
"Let's see how good you'd look under similar circumstances," my patient interrupted.
I suppressed a chuckle as Scott asked, "How bad is the blood loss?"
"Minimal."
"Continue examination," crackled from my shoulder.
"Bingo," I whispered, apparently too loudly.
"What?" echoed from my patient and Scott simultaneously.
"Jugular veins are distended. There's slight tracheal deviation to the right. There's subcutaenous emphysema on the chest wall. Left lower lobe breath sounds are absent, and the thorax is hyper resonant to percussion."
"Tension pneumo," Scott confirmed. "How's he tolerating? Will he last until the posse arrives?"
"No. He's becoming more cyanotic, and air hunger's increasing. I'm going to do an emergency decompress."
"That's outside your scope of practice in this state," Scott reminded me. "Just sit tight while I put a move on the reinforcements."
"There's no time. I'm doing it."
"I'm not backing you this time."
"I'm not asking you to. I'm going to do what will let me sleep at night." I pulled my wallet from my back pocket and removed a condom.
"Damn, I don't even get dinner first?" escaped the kid's lips as a bolt of pain seized him.
"Tell you what," I replied, "you lay off the wisecracks, since I don't think either of us has the strength for it, and I'll tell you what's going on."
I continued, "Brutally honest--you're in shock. Your blood pressure is down, and your pulse and breathing are up. Your left lung has collapsed. That crackling sound you heard when I pushed on your chest is air under the skin. Your skin is becoming bluer every moment from lack of oxygen. Your breathing is becoming more labored. If I don't re-expand your lung, soon, you'll die."
"So what's the bad news?" "Damn, this kid's a fighter," I thought to myself.
"I'm going to put a big needle, a really big needle, through this condom and stick it between your fifth and sixth ribs, just below your nipple and in line with your armpit. I'll leave the plastic catheter that's around the needle there until you get to the hospital where they can put in a chest tube."
"Will it hurt?"
"Truth?"
"Truth," he responded.
"Probably."
"I'm ready," he confirmed as I ripped the last piece of his shirt out of my way. He inhaled deeply as I pushed firmly. He blacked out just after I heard the wonderful sound of air coming through the catheter.
We finally made it to the hospital where Cathy, one of the ward clerks, followed us to Trauma-1 (the room). "Did you get a name?" she asked. As I finished exhaling the report to the emergency room nurse who was assuming care of him, I answered Cathy with a "no."
As the door separating the triage room opened for another patient being escorted back, some curly-headed blond kid shouted at us through the admission window that faces the waiting room, "His name is Joshua Chasez."
TO BE CONTINUED...
I know there was no sex, etc., in this first installment, but it is merely the backdrop to the rest of the story. I sincerely hope you enjoyed it and will continue to do so with the forthcoming chapters. Comments are welcome: mnhunter@midsouth.rr.com