Title: Snakebite!
Author: Nicksfriend
Rating:k+
Spoilers: None
Disclaimer: Bottom line...they belong to CBS and to those who make millions!
This will be a short and sweet Nick angst story, few chapters but lots of Nick hurt and comfort.
I just hate when I post something and I have to go back and correct my silly mistakes...I just want to smack myself!
Grissom looked up to see Brass who was now cursing into his radio, a feeling of panic creeping into his mind as he glanced down at Nick, his pale,sweaty features telling him that Nick needed medical attention and that he needed it now.
"What the hell do you mean it will be another thirty minutes? My guy won't make it that long!"Brass was screaming into the radio, hearing only that the copter was busy with another call and it would be a while before they could respond.
"Jim, we can't wait, we could have him back to Vegas before the copter gets here." Catherine explained as she tried to wipe away the sweat from Nick's face, it was profuse and he was getting dehydrated quickly, increasing the potency of the venom in his system. If they didn't act immediately Nick could die.
Grissom was studying the situation,"How much do you think he weighs?" He finally asked.
"Probably around a hundred eighty." Catherine guessed, knowing that Nick had recently lost weight due to the flu bug he had when Gregg came to work and passed it around to everybody.
"We need to get him and us out of this gorge, it's a snake pit." Looking around and seeing multiple snake nests, Grissom knew things could get a lot worse.
She nodded and licked her dry lips, "We can do it."
Brass already at their sides ready to assist,"Let's do it." Hoping that their efforts would help get Nick out of this snake infested hell.
"We need to stabilize the leg with the bites, if it moves the venom moves." Grissom instructed as he placed his arms underneath Nick's and grabbed his wrists.
Brass grabbed underneath Nick's waist and Catherine grabbed the legs, her focus on the right leg more,keeping it still, making sure it didn't move.
Grissom looked at his coworkers, it had to be done,"On the count of three, okay? One, two and three!" they all lifted at the same time, seeing how precarious the gorge was going to be going back up. "We need to keep his head up and the legs lower than hte level of his heart according to what Nick instructed before he passed out.
"This isn't going to be easy." Brass added, seeing the loose rocks and steep incline.
"We don't have a choice." Catherine added. "We need to get Nick out of here, he isn't looking good." His skin taking on a sickly pallor and the area of his right leg becoming more purple in color, like a deepening bruise.
As they started up, Grissom now facing backwards, getting good footholds in the loose soil, keeping a firm grip on Nick's wrists, hoping he didn't break a bone due to how tight he was having to hold on to the man as he pushed himself up the steep grade. Every once in a while someone feeling their hold loosen and having to stop to regain their grips, the moisture on their bodies,especially their hands causing a problem with holding on to his sweaty, feverish body.
Finally they made it to the top of the hill. Quickly they opened the door to the Tahoe, and placed Nick inside. Grissom crawled into the driver's seat and turned on the ignition, flipping the nob of the air conditioning to full blast, the heat took a few minutes to escape the vehicle but Catherine had already climbed inside and placed Nick's head into her shoulder, keeping his waist and chest elevated as Grissom had instructed her to do earlier.
Brass was on the phone again, the med flight helicopter still on another call. "They're instructing us to take him back to Vegas, to Desert Palm, they have specialist that have already been notified of Nick's situation." Brass informed the two CSI'S, frustrated that Nick was unable to get the medical assistance he so desperately needed right now.
"What are we talking about ? A forty minute drive, Nick doesn't have forty minutes Gil, I'm pretty sure his blood pressure is low, just the pale color of his skin, his diaphoresis and his fast heartrate are signs of shock." Catherine expressed her concerns out loud hoping that there was another option, hoping that Nick wouldn't die.
"There's a small medical clinic up the road, I think, or there use to be at least, for the locals. I wonder if they're still open? They might be able to assist until we can get a copter to transport Nick back to Vegas." Grissom was thinking out loud, knowing that it could be closed and that losing valuable time looking for it could put Nick at a greater risk.
Brass got on it, pulling out his radio and making a call. When he had finished he pointed towards the road ahead and gave them directions, "I'll be there as soon as I get an officer to take over and another team to deal with these two deaths."
Grissom nodded and took off, leaving a plume of dust and dry dirt in the air, leaving Brass behind, worried about his friend, someone he had considered Nick more like a son than a friend.
Grissom was looking for the sign to the clinic, Catherine was also looking when she heard a small, weak voice from below her."Am I dead yet?"
She smiled down and shook her head, "Listen Nick Stokes, I don't want to hear those words again, you're going to be fine." giving him a sweet smile and a firm squeeze to his shoulder. "How are you feeling?"
"My leg is killing me,it feels like it's on fire," He suddenly realized that he was in a car. "Where are we going?"
"The med flight helicopter was on another call, we're going to a local clinic, they should be prepared for snake bites, especially given the location of the clinic." She explained feeling that they had somehow let him down with their inability to get him to a hospital.
"Might be better, they know how to deal with snake bites." He grimaced as he tried to move the sore leg, the swelling had increased the size of the leg to almost triple in such a short amount of time, the color telling him necrosis had already started, the pain almost unbearable. He could also feel his body slipping into shock, his pressure must be low, his vision blurring, he knew that he needed fluids and antivenom; he knew his chances were decreasing with the delay, his mind racing to determine if they could do anything else but he was honestly just too sick to assist anymore.
"I found it!" Grissom yelled from the front, an younger man was standing outside with another older gentleman, a gurney in place to get Nick inside.
Grissom quickly pulled the Tahoe into the parking area, the two men wasting no time in getting Nick onto the gurney, already assessing his vitals as they pushed him through the doors of the small clinic.
"He's really hypotensive, 80/40!" Yelled the younger man, who was already starting an intravenous line, the fluids already hung with IV tubing on a pump ready to go, the fluids ready to attach as soon as there was blood return in the angiocath determined from the needle stick; then it was done, Nick was finally receiving a bolus of fluids to increase his blood pressure, the antivenom being held until the pressure could be elevated.
The older man was collecting blood for lab tests from the other arm, seeing that the pressure was low he reached over and grabbed a pre-prepared syringe with adrenaline and jabbed it into Nick's left upper leg.
"Give me another pressure in three minutes John." He instructed as he continued to busy himself placing another intravenous line and removing Nick's clothing, a sheet draped over his warm body.
"Temp is one-hundred and three,sats are 84 percent." Both numbers creating a new flurry of activity. Oxygen was applied, a 100 percent non-rebreather mask over Nick's face and ice packs underneath his armpits, neck and to his forehead.
Catherine and Grissom watched from the corner of the room, the proficient men knew what they were doing.
Suddenly a woman entered, dressed in blue jeans, a flowered top and a lab coat, she quickly collected the lab vials and exited the room. She new her task and went straight to work.
The older man started asking questions to Nick, who seemed to having difficulty answering anything, he was mumbling but his numb lips and tongue was preventing any understanding of the answers to the questions so he turned and looked at the two in the corner. He motioned them nearer and they approached, seeing that Nick was now pinking up, the leg now splinted as if he had broken it,keeping the venom from spreading throughout his blood stream.
"What bit him?" the older man asked, needing the information to be able to treat him appropriately.
"Western Diamondback, approximately forty-minutes ago." Grissom answered.
"Looks as if he got him twice." The older man remarked as he took in the site of four fang marks. A new set of vitals obtained as he administered a dose of prednisone and a dose of benadryl through the IV line.
"We don't have time to test for allergy to the antivenom, it's usually a waste of time testing it anyways. He needs the antivenom now and so as soon as his blood pressure is up I'm going to start giving him his first dose, see how he reacts to the medication."
"Pressure is up now, 110/72." The younger man informed as he continued giving Nick medications and adjusting his IV rate to flow as fast as they could get it into his vein, the second line also hooked to fluids and a bolus of fluids started but with a bag of adrenaline attached to a secondary port with a different pump.
"Start his first vial of Polyvalent, keep an eye on the pressure, tell me if there is any drop, we will increase if no reaction." The older man was watching his patient struggle with the pain, knowing that he couldn't administer anything orally, that his patient would throw it up and intravenous pain meds were out of the question until the blood pressure was stabilized.
A combination of sweat and tears streaming down his face, he was keeping his need to scream intact, wanting to be strong but he was failing, every once in a while letting out a audible moan or a muffled groan.
Catherine grabbed Nick's hand, tears streaming down her face, seeing how much pain he was experiencing, hoping that she could give him some comfort until analgesics could be administered.
Grissom had never seen his young CSI in this much pain before and it tore at him, knowing how much Nick was suffering.
"Please, give me something for pain." he finally begged as the pain in his leg was causing him to almost convulse.
"Listen, we'll give you a subcutaneous dose of morphine, it'll take the edge off the pain but I need to keep your blood pressure up for the antivenom right now, Okay?" The older man explained as his assistant drew up the morphine in a syringe and rubbed an alcohol pad over his right upper arm and injected the med,relief didn't come quickly but after a few minutes it eased and Nick was able to relax some, enough to allow the continued treatment without interruption.
Nick became quiet, attempting to listen to what was occurring around him, tubes and needles were being placed everywhere, the leads of a heart monitor were being placed on his chest and a foley catheter was being inserted,Catherine turning her head to allow his privacy but never letting go of his hand.
Grissom now standing facing his CSI, giving moral support for what was happening to him,knowing that he was in part responsible for what had happened to Nick.
"Pressure is dropping again." The younger man shouted,"84/48."
Again the adrenaline was given but this time intravenously and they cut off the antivenom so they could stabilize the pressure again,it was going to be slow going, the blood loss and dehydration both playing a part in the low pressure and now the antivenom effecting the pressure too.
The woman re-entered the treatment area and gave the doctor a piece of paper,"The coagulation times are way off, we'll need to give him at least another amp of the antivenom when we finish with this one, also we'll need more bloodwork in another two and half hours." He directed the woman and his assistant.
"We really need to get him transported to a hospital." Catherine interjected into the conversation of the medical team.
"Listen, we can't move him until he's stable and right now he isn't stable. We have all the equipment needed to treat him right here." The older man explained as he took another look at the still bleeding leg.
Grissom was feeling as if they should allow his transport to a larger facility but understanding that Nick might not survive the flight."Catherine, let them do their job. Nick's in good hands here." Seeing that the expertise of the team ,who were assisting Nick's condition and that he was basically getting one on one care, something he might not get in a larger facility.
The older man looked down at the lab numbers again and gave out another order, "He needs a unit of blood." He looked down at Nick, "Do you know your blood type son?"
Nick nodded and pointed towards Catherine.
"He's O positive." She had always felt like the mother of the team, knowing all of their blood types in case of an emergency.
"Good, Let's get a unit of O positive up and another waiting just in case," He ordered,still examining the numbers on the paper.
"Also, let's start him on an antibiotic." he turned to talk to the Catherine,"Any allergies?"
"Only to ants, red ants." she remarked,"He had a anaphylactic reaction to multiple ant stings about three years ago."
The doctor nodded and looked down at his flushed patient,"Listen, we're going to give you something else for pain as soon we can."
Nick nodded his head and closed his eyes, attempting to block out the pain in his leg, which was at the point of making him want to scream but he was holding on the best he could.
"Pressure is back up, 112/66." The assistant reached over, cutting the antivenom pump back on.
"What's his temp?" The older man questioned noticing the redness to Nick's face was increasing.
The assistant stuck the thermometer in Nick's mouth and in a few seconds the machine beeped, the number was one hundred four point one."104.1." The assistant looking over to the EKG monitor, noticing the increase in his patient's heartrate, "Heartrate's up to 130."
The doctor didn't seem surprised," The heartrate goes up ten beats for every increase in degree of temperature. He needs some Tylenol,let's give him a Tylenol suppository and a tepid bath." He ordered as his team went into action.
The assistant John nodded and the woman who had run the lab earlier grabbed a wash basin and started filling it with tepid water.Grissom and Catherine now having to step back to allow the team to do their jobs.
A knock on the door went unnoticed due to how focused everybody was on saving their patient. the door opened and a woman from the desk peaked inside,"We have another visitor outside, a Jim Brass." she announced.
"I'll go out and update Jim, I'll be back in a few minutes." Grissom whispered to Catherine, not wanting to disturb the others working on Nick.
She turned to Grissom and pulled him into a hug,"Are we doing the right thing?" she whispered into his ear.
Grissom gave her a comforting squeeze and nodded,"I think they're giving him the best of care." He pulled back and gave her a small smile, wanting her to feel better about the clinic. The group of medical personnel seemed very knowledgeable and confident regarding the treatments they were giving to Nick.
Nick allowed the bath and even the insertion of the Tylenol, his leg beginning to feel as if a knife was stabbing it, he wished he could just get relief, his nausea starting to worsen with the pain and the multiple medications he was receiving.
"I think I'm going to throw up." He announced to nobody in particular, hoping that the oxygen mask wasn't muffling his plea and that his slurred speech was being understood,the numbness of his tongue and lips creating a communication problem.
The older man saw that his patient was having difficulty, reaching over and pulling the oxygen mask off his patient's face and placing a small emesis basin to his mouth, feeling that he might be getting nauseous from the bites and from the meds.
Within seconds he was vomiting and the team was rolling him onto his side, his aching leg taking a beating form the slighest oft movements."Dammit, it hurts!Please help me, please!" Nick yelled out, the team understanding that their patient had experienced enough, his limits of pain and suffering at its maximum.
"Can he please have something for pain and nausea?" Catherine demanded, seeing that Nick was in severe pain and it was ripping her apart seeing his suffering so intense.
The older man nodded,"Let's give him some Phenergan and Demerol, start with the lowest doses and let's see how he does." Nick's pressure already dropping some with the vomiting episode, a vagal nerve response.
The younger assistant, John adjusted the fluids again and drew up the meds from the two vials and injected it into the port opposite of the adrenaline line, not wanting to mix the medications.
Nick was in a great deal of pain though and he started to writhe about on the gurney, attempting to get in a position of relief but finding none. The fever and pain starting to cause him to hallucinate.
"Hold his arms down or we'll lose the IV's." The doctor instructed as his team grabbed soft restraints and placed them on both wrists and his right splinted leg to keep it still.
There were explanations being given to their patient but he was lost in a world of pain and fever, unable to react to their pleas of staying still. The doctor knowing that anymore medication would endanger his blood pressure by dropping it even more than it already was and that could cause him to go into cardiac arrest.
"I need five milligrams of Valium." The older man finally ordered his assistant.
"His pressure is too low." The assistant looked over to the low numbers,"It's 100/52, heartrate is increasing too."
"If we don't do something now we could lose him." He picked up the vial and drew up the med then injected it into the IV port, hoping that his patient would calm down,knowing it was the combination of everything that had created his confusion.
The assistant looked over and shook his head," Pressure is dropping too fast, we need to do something now!" He shouted, wanting to help his crashing patient, seeing that the woman who had brought him in to the clinic was panicking,both waiting for the doctor to make the next move.
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