In my headcanon, Jan is ex-Navy. I meet a lot of military and ex-military people, and the Navy medics I know are some of the calmest, most chilled-out people on the planet. I mean, it's not as though you have anywhere to go and freak out if you're stationed on a ship. There might be a fic about Jan's backstory in the works soon if I can muster the brainpower.
Metaclopromide is an anti-sickness drug sometimes given to people who have to be secured on a spinal board (I can imagine it would be hard to log-roll someone so they can be sick in the back of a moving ambo, let alone with only one medic). Reviews would be awesome-if you came to me via Sherlock fanfic, you'll know I haven't written anything in about five years, so imma need feedback, I think.
Iain whimpered, the agonising pain of his broken ribs breaking his composure. As Ruby slid her hand into his, his mouth set into a firm line, breath panting through his nose in short, sharp bursts.
Dylan, always observant, noticed this. "Iain, I'm going to give you some ketamine for the pain. You need to be able to breathe properly or you're going to tire, alright?"
Iain nodded minutely, squeezing hard on Ruby's fingers and letting out a brittle cry as they hit a bump in the road.
Jan turned in the driver's seat, saying that they were nearly there, as Dylan pushed the painkiller in.
Iain's eyes flickered shut again as the drug took hold, and the ambulance sped along the motorway. Dylan had radioed ahead, and Ruby kept a close eye on his vitals, eyes flicking from monitor to face and back again.
They pulled in to the ambulance bay, moving quickly to get the trolley down to the tarmac.
Connie stood waiting at the door of the ED, alongside Rash, Robyn and David. Noel peered anxiously over from the desk.
"This is Iain, 35, thrown approximately ten feet by an explosion. Burns and oedema to the upper airway, surgical airway put in at scene. He's got a depressed skull fracture to the left hand side, broken clavicle and multiple broken ribs both on the left, and query internal bleeding. Sats are 93, pulse is 98, BP's 110 over 66 and he's had five of morphine, five of ketamine and ten of metoclopramide. GCS was 5, came up to 13 en route, now 11."
Connie nodded, face the tiniest bit shadowed.
"Right, bed number three please."
Dylan stood at the head of the trolley, watching the trach carefully for signs of movement.
"Everyone got a bit? Over on my count, gently please. One, two, three."
They set him on the bed smoothly, David doing his best to rouse him as they unwrapped the blankets from the scoop.
"Iain? Iain, open your eyes for me. You're in the ED."
Sluggishly, they opened, green eyes blinking owlishly up at the ceiling, and David could see him trying to catch up. Iain was dazed, clammy as he squeezed his fingers. He let out a hoarse, strangled yell as Connie palpated his ribs. Robyn pinched his thumbnail between thumb and forefinger to gauge his pain response, and he slowly pushed back against her hands with a low moan.
"Responding to pain, responding to commands but incoherent sounds, current GCS of 11."
"Right, I want a full trauma set, chest, c-spine, and an abdo ultrasound and bleep the neurosurgeons please. FBCs, U&Es, ABG and crossmatch two units. Rash, watch out for respiratory acidosis and keep an eye on his lactate..."
He'd heard it so many times before. Wasn't even sure who they were talking about, to be honest. Everything was sort of...vague. He let the words wash over him, the ache in his head shaking the thoughts loose. His train of thought skittered away, and he just wanted to go to sleep, but David kept squeezing his hands...
"Flail chest..."
"Intracranial bleed..."
"Laceration to the spleen..."
"Cardiac tamponade..."
"Decompensating..."
"BP's dropping!"
"He's bleeding from somewhere, get me the fast scanner and put the CT up..."
"There."
Dylan's voice, ringing clear. "Small laceration to the liver and another big one on the back of the spleen. Must've been pushed against the ribs. Lots of free fluid. Little bit in the pericardium."
"Bl..p...surg...get him...theat..re...BP...acidotic...numbers..."
David's hands were back, gently resting on his wrist, and he focused on them as the lift doors pinged and finally he could sleep.