Living on a Prayer Ch. 4
Disclaimer: I don't anything recognizable in this story, nor am I making any profit from it.
Author's Note: Sorry for the long delay. Once again, I have no medical knowledge so please forgive any inconsistencies in treatment.
Previously: Holding onto the side of the boat as it sped towards help, Dean's eyes were suddenly drawn to what looked to be an outdoor chapel with a cross located in the middle of it. He closed his eyes and silently prayed that his brother would live to see it.
Approximately Thirty Minutes Later:
"Okay people, we have a young teen due to arrive any minute with a severe laceration to his right side causing penetration trauma and extreme blood loss," Dr. Brad Folsom announced to his team as they prepared the ER room for the arrival of their young patient. Time was of the essence if they were going to save the boy. From what they had been told, the young man had already coded once on the flight in.
"Janie," call the lab and tell them I want at least two units of O negative blood STAT and another four units on standby," Brad called out as he pulled on the protective attire he would need to treat his young patient. He knew the young man could most likely be transfused safely with O negative since it was the universal blood type if his family was not available to give blood at the time.
"Yes, Dr. Folsom, right away" the nurse replied as she quickly picked up the phone to give the order. The helicopter should be landing any moment.
"Sarah, I want a crash cart stationed here in the room, just in case" Brad ordered of another nurse as he watched Nurse Alison lay out the equipment he would need to assess their critical patient. He hoped and prayed the kid wouldn't code again as each time it happened, it lessened the patient's chances for survival.
"Alright people, here we go," he called out as he heard the message come in that the helicopter was now landing on the roof. Watching as everyone quickly took their stations, Dr. Folsom took a deep breath to prepare for the incoming patient. Damn, but he hated it when it was children who were going through life threatening emergencies. He would make sure to do everything within his power, and then some, to make sure that this kid survived. He didn't have the time to contemplate more as the door was suddenly thrust open and a gurney carrying the young teen was rushed inside.
"What are we looking at?" Brad inquired of the EMT as he applied his stethoscope to the young man's chest to listen to his heart and lung sounds"
"The patient is in severe shock from a penetrating wound to the abdominal area. His BP is 90 over 50. He crashed on us coming in and I had to defibrillate twice to bring him back," EMT Mack Johnson answered as he hung the IV bag on the provided pole at the top of the medical bed while his partner and the doctor transferred Sam to the bed in the ER. "We have already administered two IV's with lactated ringers and have started him on a third to replenish the lost fluids."
"Is he allergic to any known medicines?" Brad inquired as he quickly noted the bruised area on Sam's stomach and quickly palpated it for rigidity to determine if there was any internal bleeding.
"Only penicillin," according to his family," Mack answered as he walked to the end of the bed and started pulling off the patients shoes as the nurses went about their work of charting the patient's blood pressure, temperature, and oxygen saturation levels."
"Somebody get this kid's jeans off," Dr. Folsom called out as he unsnapped the jeans and lowered the zipper so he could prod further down on Sam's stomach since there was some definitely swelling in the area of the trauma.
"Sarah, call down to Cardiology and tell them I am redlining a patient down for a CT scan and ultrasound of the abdominal area. If I am right, this kid has a badly lacerated liver and we need to get him to surgery stat," Dr. Brad Folsom stated as he peeled off his latex gloves.
"Do we know if his family has arrived yet?" Brad asked as then pulled off his bloody scrubs and started walking towards the door in preparation to talk to his patient's family so he could get surgical consent.
"They should be arriving any minute if they're not already here," the EMT answered as he followed Brad out the door. "The police were supposed to escort them in."
~~Supernatural~~
Arriving at Huggins Hospital, Dean and John quickly entered through the sliding glass doors to the ER and swiftly strode up to the nurse's desk.
"Hi, my name is John Winchester and my son was flown in by helicopter a little while ago," John informed the nurse as he shifted from foot to foot in agitation.
"The doctor is with your son now," the desk nurse informed John as she handed over some forms for him to fill out on Sam's medical history. "If you will have a seat right over there, I will let you know when I have more information."
"Thanks," John replied as he led Dean over to a couple of chairs in the corner of the waiting room and prompted his eldest to sit.
"Damn it Dad. I can't just sit here and twiddle my thumbs when I know Sammy is back there somewhere," Dean cursed in agitation as he bounced back up from the chair. 'He needs me."
"Dean, sit…" John's voice trailed off as he heard a voice calling out, "Family of Sam Winchester?
Standing up, John nervously awaited for the doctor to approach. "How's Sammy? How is my son?" John inquired as he looked imploringly at the doctor for information.
"Mr. Winchester, you son is in critical condition. He coded twice on the flight in, but the EMT's were able to revive him," Brad started, only to stop his spiel as he noticed the young man beside Sam's father go a deathly shade of white.
"Son, I need you to sit down for me and calm down,' Brad voiced soothingly as he led Dean over to a chair and pushed him into a sitting position before taking Dean's wrist in his hand and assessing the pulse.
"I'm…M'okay," whispered Dean as he looked at the doctor with moist eyes. "Just tell us about Sammy. He is ali-alive. Ri-Right?"
"He is…for now," Brad emphasized, letting his patient's family know just how critical Sam was. "I have sent him down to Cardiology for a couple of scans. I believe he has a severely lacerated liver which is causing internal bleeding. I need to operate as soon as possible so that we can get the bleeding under control, and hopefully stopped."
"Wh-Where do I sign," John asked wanting his youngest child to have every chance possible.
"The desk nurse will have the surgical form. I'll make sure it is brought over," Brad answered as he tugged a hand through his hair.
"Another thing I need to let you know is that Sam is most likely going to need some blood transfusions during surgery. It would be better if it came from a family member…" his voice trailed off as he watched both Winchesters shed their jackets and begin to roll up their sleeves.
"Where do we donate?" Dean asked, willing to give all of his blood if that was what it took to make sure his baby brother would survive.
"I'll have somebody come out to escort you to the lab," Brad answered with a smile as he pushed himself to a standing position. He really needed to get prepped for surgery.
~~Supernatural~~
Gazing at the CT scan and Ultrasound images in the ER, Brad could easily ascertain that his patient had sustained a grade 4 liver injury with active bleeding, one that would indeed require surgery to fix.
"Okay, let's get this kid to the OR," Brad voiced as he and his team of nurses prepared Sam for transport. "Also, get somebody down to the lab. His family is donating blood right now. I want it typed and cross-matched ASAP and delivered to the OR."
"Yes Doctor," Nurse Alison answered as she unlocked the wheels to the portable gurney and the team rushed Sam out of the room. Watching as the young man was wheeled away; she said a quick prayer for him as she made her way to the lab to do as requested.
Arriving at the OR just moments later, Brad scrubbed up as his team of OR nurses went to work preparing his young patient for the surgery.
Knowing that direct control of the bleeding was of utmost importance in this type of injury, Brad went to work on managing the penetrative injury. Calling for four units of blood to be hung for the activation of massive blood transfusion, he cut into Sam's stomach and began his search for the damaged area. Finding it quickly, he put some direct pressure on the area for approximately fifteen minutes to stop the bleeding, or at least slow it down. Once the bleeding has considerably slowed, he quickly went to work repairing the venous injury and then afterwards, packed the area with perahepatic packing. Once that was finished, he did a temporary closing of the abdominal area knowing he would have to go in later to check for success before fully closing the area.
Washing up as his patient was transferred to the ICU for intensive care and observation, Brad thought about what he would say to the family of the young man he had just operated on. The next twenty four hours were going to be crucial for his survival. And with the massive blood lost the kid had sustained before reaching the hospital, he could only pray the kid had the strength he would need from the transfusion given, especially considering how low his blood pressure was at the moment.
~~Supernatural~~
Walking up to Sam's family who was now waiting in the OR waiting room, Brad pulled off his surgical cap and approached the pair who were standing to greet him.
"Please, just tell me my son survived the surgery?" John pleaded as he took in the concerned look on the doctor's face.
"Yes, Sam did make it through the surgery without coding on the table thankfully," Brad informed the angst-ridden family before him. "However, I need to tell you now that the next twenty four hours are critical. Sam has lost an enormous amount of blood and he is quite weak. We're having trouble maintaining his blood pressure and stabilizing his oxygen stats. Your son's life is in God's hands now."
"How long until we can see Sam again?" John asked as he scrubbed a calloused hand across his lower jaw. They hadn't seen Sammy since he was put into the helicopter and it was nearly killing him. He could only imagine what it was doing to Dean. They had hoped to see Sam before surgery, but had been too pushed before time since surgery was of the essence.
Chewing on his bottom lip as a lone tear trailed down his face, the words the doctor had just emitted kept going through Dean's mind. "Your son's life is in God's hands now."
"I…I need to go do so-something," Dean stammered before rushing out the door, leaving his father and the doctor to wonder what the hell had just happened and where in the world he was going?"
TBC Any ideas as to what Dean is up to and where he might be going?