I was resting on the on-call room, when my pager went off. I groaned, sat up, grabbing my white coat. I checked the pager.
"Shit" I hissed running.
It was from the ER. I took the stairs, running; it would be faster than the elevator. When I got to the emergency room, I entered the room where the mess was.
"What's happening?" I asked putting on gloves.
"We're fine here!" a doctor said, starting compressions on the woman. That didn't look fine. "There is a kid in the other room!"
I ran to the other room, and grabbed the chart a nurse extended.
"5-years-old, female. Car accident" I mumbled as I read, and watched the med students.
The girl was small, with blond hair. She was all bloody, and unconscious.
"She wasn't wearing seatbelt!" I turned at hearing my dad's voice.
"You know her?" I asked approaching and checking the vitals.
"No. I attended the accident scene" dad said.
"I need you to wait outside"
"Bella…"
"I need you to wait outside, Chief Swan" I said forcefully.
He nodded, still looking at the girl and walked out.
"Broken ribs. One punctured the lung" a med student informed.
"We have internal damage" the other said.
"Get an ultrasound" I asked Nurse Weber who ran out, "Vitals?"
"She's stable"
"That's impossible" I mumbled.
I got my penlight, to check her pupils. It was impossible for a child this small have that damage and be stable. I flashed the light in her pupils, and cursed.
"Who the fuck said she was responsive?" I yelled. "Call a neurologist! Now!"
"Irresponsive?" a med student asked.
I nodded and checked her vitals.
"Her heart rate is wrong" I said.
"It's normal. A little fast, but normal for the situation" the med student said.
"Heard of 'calm before the storm'? This is the case. No one would have such heart rate when so damaged"
Angela got back with the ultrasound, and a neurologist followed.
"What do we have?" he asked tiredly.
"She's irresponsive. Her vitals are too calm for so much damage" I informed.
He called a fellow from neurology, and they evaluated the girl, while I checked the internal damage.
"Call surgery!" I demanded, "We have internal bleeding! Say it's urgent"
"Her intracranial pressure it's too low" the neurologist informed, "I'll join the surgery"
The surgery residents came, and took the little girl to surgery. I changed gloves and sterilized apron and went to help with the woman.
"Needing help?" I asked.
"Change with me please" the doctor said.
He pulled away, and I took over the compressions.
"Clear!" another doctor called.
I pulled away and he defibrillated. We watched the monitor. Her heart beat a couple times normally, and then… The beeping turned into a continuous sound.
"Asystole" I called starting the frenetic compressions.
They put away the defibrillator, and the nurses started to rush with drugs.
"Epi is in!" a nurse said.
After two minutes, I was panting for air, and still nothing. Another doc took over and I caught my breath while watching the monitors.
"Should I inject another dose of epi?" a nurse asked.
"Try norepinephrine" I said.
"It can give neurologic damage" a doctor disagreed.
"Epinephrine isn't working! I think it's better a damaged living woman than a dead one!" I shouted.
"Give the damn norepinephrine!" he called to the nurse.
After almost five minutes with CPR and drugs, we still didn't have response.
"Time of death" a doctor sighed and looked in the clock, "2:37"
We all took our gloves off, and a nurse disconnected the machines. A doctor asked the med students to close her up, and I got out, yanking the bloody yellow apron. I threw it in the garbage, and walked to the waiting room. Dad was still there. He got up and looked at me expectantly.
"How's the girl?" he asked.
"In surgery. But not good. She has internal bleeding in the abdomen, a punctured lung, and probably neurologic damage, she had intracranial pressure low" I sighed, "I'll check on her soon"
"Alright. Thank you"
"The woman died" I said running my fingers through my hair, "We spent the whole time trying to resuscitate, but we lost her"
"I know it sounds insensible, but I can't be sad by it" dad said.
"Dad!"
"The woman was running, Bells. Like she was running from hell. She had alcohol in the car! And a little girl in the backseat without car seat, or seatbelt!"
I sighed, my dad sometimes got too emotional with things at work.
"Did you contact the family?" I asked.
"One of the officers is trying to get information"
"Okay" I sighed.
"You seem tired"
"I've been working for almost a whole day"
"You need to rest, Bella"
"I need to work"
"Stubborn" he said amusedly. "Coffee?"
"Sounds like heaven, dad" I said smiling weakly.
I got to called the pediatric floor, informing I had been in the ER, and that I was going to get some coffee, anything page me.
"I asked them to call you" dad said as we got our coffees. "I needed the best pediatrician to the girl"
"Thank you, dad" I said smiling, "But there wasn't much I could do"
"You did everything you could?"
"Of course"
"Then it's alright. You did everything you could, you're just human, Bella."
We finished coffee talking about a thanksgiving party. When we finished, I got back, and called the surgical floor.
"Yes. I'm Doctor Swan, I'm from the pediatric floor, and attended a little girl in the ER. She was sent to surgery about an hour ago" I informed the nurse who answered.
"She's getting out, Doctor Swan. We're sending her to ICU. Should I inform you're her doctor?"
"Yes, please. Thank you" I said.
I hung up, and turned to my dad.
"So?" he asked.
"She's getting out of surgery. I'm her doctor. I'll go check on her"
"Good" he mumbled and sighed, "I got the family information"
"I'll call them" I sighed.
He gave me the information he had and I dialed the number.