Page 48 of Dr. Alaska
“Should I wait for you?” His voice was as flat as the low ambient light around them.
“No. Take care of the babies. I’ll get a ride back later.”
“Sure.” He shook his head. “We were done anyway.” He grasped Kenai’s neckline and slowly trudged across the parking lot with the team and the attached sled.
Her chest ached at the sight of this rugged man, believing that his dreams had been broken in a matter of moments. For a person who fixed problems for a living, she didn’t have an answer to this situation.
As staff wheeled Nick into the building, Lee followed, turning sideways to sneak in the sliding doors. No staff badge on her today.
The doors closed on Randy’s big, gaping mouth. He could stay outside for all she cared. Or he could sit in the waiting area and think about new ways to be a jerk.
She gritted her teeth.
Lee needed to change clothes and assist in the ED. When she had spoken with Amberlyn before leaving the accident site, it sounded like the on-call doc, Paul, was busy with a difficult labor and likely couldn’t break away.
Snagging a generic staff badge from the HUC, she headed into the locker room, shucked off the winter gear, and pulled on fresh scrubs. Thank goodness she kept an extra pair of labor shoes in her locker. The fit of her thick wool-socked feet into the well-worn Danskos was tight, but it worked. Without a hat on, her hair stood up in strange angles, and so she snagged a patterned cloth bouffant cap and shoved all of her hair beneath it.
Shrugging into her lab coat and looping her stethoscope over her neck, she entered the first trauma bay. Lee reviewed the nursing initial assessment. Vitals were all stable. Neuro status reassuring. That was a great start.
“Let’s not move him too much until imaging is done.” She and the nurses unstrapped Nick and eased his arms out of the coat and fleece and unzipped the sides of his snow pants, stopping to remove the SAM splint on the lower leg before replacing it over his base thermal underwear layer. Then they carefully rolled him, allowing Lee to do a proper spine palpation. The nurses eased the garments out from under him with an impressive lack of jostling.
However, that small movement must have hurt. “I need something for my pain!” Nick hollered. “Please! This leg is killing me.”
Fair enough. A broken leg was miserable. “Amberlyn, please place an IV. Let’s give five milligrams of morphine IV. Can you pull rainbow labs?” Rainbow labs meant filling one of every color blood tube to have on hand until Lee knew which orders she wanted. For certain, she would run a tox screen and blood-alcohol level, which could contain key information if litigation occurred. If the lab was drawn after administering morphine, it could result in a false positive flag for opiates. Lee wanted accurate information today. Everything by the books. Nick’s health depended on it.
Maverick’s future depended on it.
“Got the blood.” Amberlyn handed the tubes to the waiting lab tech who stuck labels on and left. Then Amberlyn pushed the morphine dose through the IV hub.
Lee said, “I’d like a CT, head to butt, for a stat tele-radiology read. And an x-ray of that leg.” With Nick’s coat and fleece jacket and snow pants removed, it was easier for her to do a more in-depth exam.
She listened again with her stethoscope. Good air movement in the lungs and a regular heart rate without any rubs to indicate traumatic pericardial effusion. She also pressed on his shoulders, arms, abdomen, and pelvis. No pain.
Then Nick’s breathing sped up.
He waved his hand. “Hey, wait. Did you say CT? Is that the donut thing?” His pitch rose. “I’m claustrophobic. I can’t go in there! I can’t breathe in it!” He clawed at his neck and waved off nursing attempts to hold still as he thrashed. “Where’s Randy? This wasn’t part of the deal.”
Oh boy.
Lee had a choice. Get inadequate imaging and be unable to rule out major internal, spine, or head injuries. Or give a strong antianxiety medication, recognizing that if he had a head injury, it would be difficult to obtain accurate neurologic status assessments.
The twenty-something-year-old patient wailed and thrashed, sitting up on the bed, moving nurses along with him. Looked neurologically intact from here.
Risks versus benefits. “Two milligrams of Versed, please, Amberlyn.”
Within a few minutes of receiving the medication, Nick began to relax, and his breathing evened out. Vitals remained stable.
The nurses and radiology tech wheeled Nick back for imaging, while Lee sat in the work area to chart, draping her white coat on the back of the chair.
Where was the on-call doc, Paul? She called out to labor and delivery only to find out that he was considering a vacuum-assisted delivery, with the OR crew en route for possible C-section if the vacuum wasn’t successful. Nope, he wasn’t coming to the ED anytime soon.
She refreshed the chart on the screen. No uploaded films yet. Lee stared toward the double doors to the waiting area. As much as she disliked Randy, she should give him a quick update. He was probably worried about his nephew.
As she approached the waiting area, she spied him on the phone, pacing. Late afternoon, on this Saturday, only a few visitors drifted in and out through the main entrance doors.
“As long as Nick plays along, we’re golden. Uh-huh. This is gonna be money. Literally.” He glanced at her and continued to walk and talk. Nothing about his expression suggested that he recognized her.
Because she looked like any generic healthcare worker in the same scrubs and surgical cap as everyone else.
