AN: hey, ok, this one won't be very acuurate, I needed a weird injury. Didn't work
out too well, but I gotta get this chap done.
"What do you have?" Mark asked.
"Female, 33, shattered ribs on the left side, fractured pelvis. Multiple lacerations to the face and extremities. Couldn't start a line in the field. Had to intubate her. BP 107/78"
"Ok, let's go to trauma 2! We need to stabilize her." Mark wheeled the gurney into the large room, practically pulling Dave away from Jing-Mei(we'll be calling her Chen. It's shorter.) Dave had been flirting quite unsuccessfully. "On my count...1..2..3! Get a moniter, start an IV and a central line. I need the sternal saw!"
"Roll her over! Check her back." Dave said, and he and Mark carefully did just that. Finding nothing but minor scratches, they turned her back over from her side to her back. "Vitals?"
"110/79." Haleh answered.
"Ok, BP rising, 3 of lidocaine. Pupils still fixed and dialated. Get that central line in! Where's the sternal saw?" Mark yelled. Haleh handed it to him and he grabbed it> He started cutting through her sternum a little faster than necessary, but not more recklessly than usual. "Chest cavity filling with blood. Get an ultrasound for the belly and get me some suction!" Malucci held the small tube and attempted to suck the blood away.
"BP falling again! 98/63!" Haleh called.
"where is all of this blood coming from?" Mark asked impatiently. Every time Malucci had the chest cavity somewhat clear, it filled again. Mark watched the bloodflow for a second and saw the source. "It's coming from the heart. Pericardium is torn, rib fragments in the left atrium!"
"Moving into the left ventricle!" Malucci called out. "What do you want to do, Dr. Green?"
"get some... some...what can we do? There are too many. They're too small. 2 of heparin to reduce clotting. Maybe that'll help. There's not much we can do, really. I don't...I've never seen this type of injury before." Mark admitted. It was one of the few times Mark ever lost his composure in the ER.
"V-fib." Malucci sighed.
"Internal paddles! Charge to 100. CLEAR!" Dave stuck the metal prong-like defibrulator into the cavity. the heart rate returned to normal. Suddenly the monitor began to beep irregularly. Malucci held up the paddles, but Mark shook his head.
"The bone fragments are in her brain. And her coronary arteries. They are cutting off the flow of blood."
"Can't we take them out?"
"It wouldn't help. Malucci, they cut up her arteries pretty badly, and now some of them are going back to the heart. We can't do anything for her now. She's bleeding from every artery in her body. There's no possible way."
"Dr. Green."
"Malucci, we've done all we can. We have no other options."
"You know she came in with two kids, right?"
"I know. These things are hard. We have to give up on this one though. If I could do anything else, I would."
"Asystole." Dave spit out the word as if it was choking him. The monitor whined and Dave glared at Mark. He turned and stormed out of the room, ripping off his gloves and going to change into a fresh pair of scrubs, leaving Mark to take care of the death kit. Haleh was already out of the room.
"I'm calling it. Time of death 22:16." Mark said to no one in particular.
"What do you have?" Mark asked.
"Female, 33, shattered ribs on the left side, fractured pelvis. Multiple lacerations to the face and extremities. Couldn't start a line in the field. Had to intubate her. BP 107/78"
"Ok, let's go to trauma 2! We need to stabilize her." Mark wheeled the gurney into the large room, practically pulling Dave away from Jing-Mei(we'll be calling her Chen. It's shorter.) Dave had been flirting quite unsuccessfully. "On my count...1..2..3! Get a moniter, start an IV and a central line. I need the sternal saw!"
"Roll her over! Check her back." Dave said, and he and Mark carefully did just that. Finding nothing but minor scratches, they turned her back over from her side to her back. "Vitals?"
"110/79." Haleh answered.
"Ok, BP rising, 3 of lidocaine. Pupils still fixed and dialated. Get that central line in! Where's the sternal saw?" Mark yelled. Haleh handed it to him and he grabbed it> He started cutting through her sternum a little faster than necessary, but not more recklessly than usual. "Chest cavity filling with blood. Get an ultrasound for the belly and get me some suction!" Malucci held the small tube and attempted to suck the blood away.
"BP falling again! 98/63!" Haleh called.
"where is all of this blood coming from?" Mark asked impatiently. Every time Malucci had the chest cavity somewhat clear, it filled again. Mark watched the bloodflow for a second and saw the source. "It's coming from the heart. Pericardium is torn, rib fragments in the left atrium!"
"Moving into the left ventricle!" Malucci called out. "What do you want to do, Dr. Green?"
"get some... some...what can we do? There are too many. They're too small. 2 of heparin to reduce clotting. Maybe that'll help. There's not much we can do, really. I don't...I've never seen this type of injury before." Mark admitted. It was one of the few times Mark ever lost his composure in the ER.
"V-fib." Malucci sighed.
"Internal paddles! Charge to 100. CLEAR!" Dave stuck the metal prong-like defibrulator into the cavity. the heart rate returned to normal. Suddenly the monitor began to beep irregularly. Malucci held up the paddles, but Mark shook his head.
"The bone fragments are in her brain. And her coronary arteries. They are cutting off the flow of blood."
"Can't we take them out?"
"It wouldn't help. Malucci, they cut up her arteries pretty badly, and now some of them are going back to the heart. We can't do anything for her now. She's bleeding from every artery in her body. There's no possible way."
"Dr. Green."
"Malucci, we've done all we can. We have no other options."
"You know she came in with two kids, right?"
"I know. These things are hard. We have to give up on this one though. If I could do anything else, I would."
"Asystole." Dave spit out the word as if it was choking him. The monitor whined and Dave glared at Mark. He turned and stormed out of the room, ripping off his gloves and going to change into a fresh pair of scrubs, leaving Mark to take care of the death kit. Haleh was already out of the room.
"I'm calling it. Time of death 22:16." Mark said to no one in particular.