Lauren rushed around the seemingly quiet ER stocking up supplies at every bed and trauma room ready for the incoming trauma that had her scared. Dealing with plenty of trauma before, Lauren had never seen anything quite like that would come through the doors of Seattle Grace in less than fifteen minutes.
"We got paged 911 down to the ER what's going on?" Derek asked as he and Meredith walked toward Lauren. He couldn't help but notice the lack of emergency in that room.
"I will tell you when everyone else decides to answer their pages"
"Lauren..."
"Not now" she snapped and continued to prepare the ER with everything they would need including surgical kits. There were going to be too many people and not enough operating rooms so she would have to make do with what she could.
"Lauren..."
"Derek just wait"
Waiting til as many of the surgical team had arrived in the ER, Lauren started handing out gowns and gloves to the curious Interns, Residents and Attendings. Singling out Mark, Lauren quickly briefed him of the situation because t would have to be them to take point on this trauma.
"We have a mass casualty situation coming in ten minutes. There has been an explosion and fire at a local elementary school" Lauren began yelling to the group gathered. Various people around the group gasped at the thought of the situation involving such young children
"There have been twenty two deaths reported already and more expected. This gas explosion happened in the cafeteria kitchen during lunchtime so we will be getting a lot of staff and children coming through these doors. Seattle Pres is taking as many of the non critical patients as they can handle but any major burn victims, smoke inhalation, blast and crush injuries are coming here so be prepared. These kids are no older than about 12 and no younger than 5 so they will already be scared and frightened. Do not make their fears any worse by treating them like any other adult patient"
"I know you've probably heard this speech from Robbins but you're going to hear it from me too" Lauren continued "This will not be like general surgery on a smaller scale; it is much bigger than that. These kids are without their parents and in a lot of pain so be gentle not just with how you treat them but with how you speak to them. Working with kids is about more than the medicine so please remember back to your psych rotations and think about their mental capacities as children"
A thousand different questions exploded from the group gathered as they asked about other Paeds Attendings, OR priority, burn care and the inexperience many of them had with paediatrics. Looking around the group, Lauren spotted Alex and quickly pulled him out to where she was standing with Mark. Whispering in his ear, she saw his face lose all its colour before he finally nodded in agreement.
"Yes I am the only Paeds Attendings available at the moment with my colleague away on leave and I understand your concern which is why Dr Karev will be my second in charge and fellow Paeds surgeon today. We will both be running back and forth between the OR and here helping out wherever we can. Along with Dr Sloan who will take point on any major burn cases, the three of us will be the ones to go to"
"Ambulances are a minute out Dr Shepherd" an ER nurse yelled out from the door.
"Attendings if there are no cases to your specialty coming through then pick up any patient and treat them. Residents and Interns please take charge and do your best work but if this all gets too much then suck it up or get the hell out of this hospital. This is not a rehearsal people, get into gear" Lauren finished up and raced out to the ambulance bay as the first of many ambulances came in. Along with Dr Hunt, she assessed the patients as they came out of the ambulances and sent them through to the ER.
"How bad is it out there Reggie?" Lauren asked one of the paramedics as he unloaded a six year old girl with burns to a large percentage of her tiny body "Sloan!" she yelled out as Lexie Grey rolled the gurney into the ER and into a trauma room for Mark to treat the girl.
"Pretty bad, the explosion blew out half the building. Search and Rescue have been digging for kids but two out of three they find are already gone" Reggie sighed and packed up the gurney as a nurse returned it "I have to get back out there. Good luck"
"Thanks. Bring us back some miracle kids ok?"
"Got it" he smiled and got back into the truck as they got ready to pick up more patients. Lauren made her way to the next ambulance and assessed the ten year old boy the paramedics were unloading.
"Benjamin James; ten years old, head trauma from being blasted into a wall, pupils are sluggish, little to no sensation in either feet and abdomen is rigid. He crashed on route, BP is still low" the paramedic rhymed off as Lauren took the gurney and started rolling it inside.
"Derek!" she yelled out as she looked around for any extra pairs of hands "Grey clear up an OR and get the portable CT and then get in here, I need an extra set of hands"
Derek rushed to his sister's aid as he assessed the situation and quickly ordered every test he could think of for the boy. They transferred the boy onto their bed and started their full work up.
"Benjamin oh my god!" A woman gasped loudly from the door to the trauma room as she saw the ten year old in a neck brace being fussed over by doctors and nurses.
"Who is this woman? Get her out of here" Derek barked loudly
"I'm Benjamin's teacher. Please save him" she cried loudly "He... He's allergic to peanuts and his blood type is B positive"
"You know your students blood types?"
"His mother is my best friend please you have to save him"
"We'll do the best we can" Lauren assured her as the nurse was finally able to take the woman out and to a waiting room. "He's bleeding internally; we have to get him to an OR Derek"
"We're going to have to work simultaneously; I need to get this haemorrhage under control"
"Grey, call the blood bank and get as much B positive as they'll give you and meet us in the OR" she ordered as they prepared the boy to take him to surgery "If you see Karev, tell him I'll be in the OR and to page me if he has to"
XXXXX
"Dr Shepherd?"
"Yes?" Derek and Lauren answered together as they heard their last name from the door of their OR. Lauren was elbow deep trying to control the perforated bowel while Derek was repairing the brain bleed.
"Dr Lauren Shepherd" Avery clarified "We need you in OR2, we've got a five year old girl with a shard of glass in her abdomen. X-ray shows it penetrating the diaphragm"
"Handle it Avery I can't walk away from this kid now"
"Me?"
"I trust you with this Jackson" Lauren insisted and looked up from her patient "Go back to the OR and open her up, I will be in there as soon as I can. You've got this"
"Ok" he nodded nervously and left the OR. Walking back into OR2, Avery scrubbed in and began the operation. He had to stop and take a deep breath but he still couldn't shake the nerves of his first solo trauma surgery.
"Are you sure Avery can handle that kind of surgery?" Derek asked after the young resident left.
"The kid's gotta learn sometime..."
"On a five year old?" Meredith asked concerned. She was Avery's friend but she knew he couldn't handle something like that, not yet.
"He can handle this just have a little faith" Lauren smiled from under her mask. Avery wasn't the most well liked Resident among the Attendings because he wasn't as good as doctors like Meredith or Alex but without a chance, Avery would never improve.
"Faith?" Derek sighed knowing his sister had never been the religious type.
"Trust me"
Lauren finished the bowel repair and controlled any extra bleeding before handing the surgery off to Meredith to finish. It was a simple repair and close and something an intern could finish but she wasn't about to patronise Derek for that.
"Page me if something goes wrong"
Walking into Avery's OR, she saw he had the surgery under control. Most residents would have opened up the pericardium and taken the shard of glass right out but Avery thought ahead and repaired what he could before it was necessary to remove the foreign object. Lauren stepped in to assist but she let Avery take point.
"Are you alright here?" Lauren asked as she checked her pager and there was a 911 to the ER. She was confident Jackson could finish this but the option of help was always there. Avery assured Lauren he was ok and that he would page her if he needed her.
Lauren got to the ER to see Bailey getting a pulse back into a smoke inhalation patient. All the doctors had been doing such an amazing job for the little notice and experience they had. She was blown away by the calibre of their talent. Getting in and taking another patient to surgery, Lauren never got the chance to go back to check on Meredith or Avery.
"Dr Shepherd?" Alex spoke from the door to the scrub room. He pulled on a mask as Lauren's young patient started to crash.
"Hold that thought for a second Karev I'm just at this kid's aorta" she sighed softly and repaired the tear in the heart. Once she was comfortable with the repair she looked up for a moment "What can I do for you Karev?"
"I just wanted to let you know that Torres took the last surgical patient up to OR3. The burn unit is at capacity but Sloan has the teacher and four kids with major burns under constant watch and everyone else is either being monitored or has been discharged. Seattle Pres sent over a few extra cases but they're under control. It's going to be a long recovery for some of these kids but we have it handled" he smiled glad to finally give such a positive report to Dr Shepherd
"Good work today Karev, your name is already on the list for a Paeds fellowship"
"Seriously?"
"Seriously" she laughed "now are you going to scrub in and help me or just stand there?"
Thoughts?
I thought Lauren needed to take charge. Lauren and Alex make a good team but would they make a good couple? Or Avery? Or Mark?