27/10/07
8:40 AM
William Harvey Hospital, Ashford
Doctor Cortellino didn't call the code until they'd done the full twenty minutes of trying; drugs, shocks, CPR never stopping for longer than it took to swap people out... He wasn't one to give up on even the two percent chance the patient had of leaving hospital alive, not until the stats said there was no chance at all. Once they had given up on the crash, Doctor Mullin walked back over to her patient. The nurse had put a hospital gown on him since she'd left.
"How is he?"
"Picking up." The nurse replied. "He's breathing a lot better, his pressures are up. He had a bit of a blink the last time I checked it."
"Let's see how he does without the mask." Doctor Mullin said, reaching for the man's face to take his oxygen mask off. He blinked as it passed his eyes. "Are you waking up?" She put a hand on his shoulder. "Hello?"
He recoiled. He recoiled so violently he fell off the other side of the bed and cried out as he hit the floor. Doctor Mullin ran round the bed, the nurse just behind her.
"Woah, sorry-"
"I don't know." His voice was slurred, hoarse, his eyes were wide with terror. He shrank back from them as he spoke, his hands were out of shape, and not moving normally. Comminuted fractures. That looked like comminuted fractures. "There's no more. I don't know any more."
"It's alright, there's-" She reached out a hand to him. He made to get up, to get away from her, but cried out and fell, and cried out again as he hit the floor.
"No more." He repeated. "Please, there's no more." She'd expected him to speak no English, or speak with an Afghani or Iraqi accent. But the man was English. There could be no doubt of that. Even as hoarse and slurred as he was, this man had learned his English in England.
"What's happening?" Doctor Hatch appeared behind Doctor Mullin.
"He just woke up and fell off the bed."
"Try to take his wrist."
Doctor Mullin reached for the arm the man was cowering behind. "It's okay." She said softly. "It's okay." She closed a hand around his forearm. He pulled away, screaming.
"He wasn't just doped with Torb, I think he's tripping on Ket. He's hallucinating." Doctor Hatch said. He straightened up. "Hey, can I get an orderly and 5 mig diazepam for IV please." He lowered his voice again. "Just back off him for a minute, see if he settles at all."
He didn't settle. Not in any meaningful sense. He stilled, he stopped screaming, but he gasped and cowered, after a minute he vomited. Haematemesis. Either he had a GI bleed or he'd swallowed a lot of blood.
"Right." Doctor Hatch said as the orderly arrived. "We're going to be gentle but firm with him, he's got multiple injuries, he's tripping, he's very, very scared. We're going to restrain to sedate to relieve the distress. We're going to drop him on to his front, then fit an extension line to his catheter and give the sedation. Are we clear?"
The man wasn't strong enough to put up much of a fight, but he screamed in either pain or terror from the moment they reached for him. Doctor Hatch and the Orderly pinned him, Doctor Mullin swapped the lines and gave the drug, slowly. His screams gave way to sobs after a minute or two, he stopped struggling. He fought the sedation, protested incoherently, shook his head and left flecks of bloody, foul-smelling spit on the floor.
"Think he's down?" Doctor Mullin asked after a minute. Doctor Hatch nodded and let go of the patient. He didn't move. Together they lifted him back on to the bed.
"Set up a xylazine and midazolam infusion, leave it for at least an hour to make sure that ketamine's gone." Doctor Hatch said. "We can't give him methadone yet, though he probably needs it. Get a set of fingerprints from him and take photographs, I bet someone is missing him. Then get on the phone to Truro. If he's not torture, what the hell is? Don't take any other patients until you've done it."
Code: Series of measures, including CPR, used as a last ditch effort against death. Typically poorly successful.
Comminuted fractures: Multiple fractures in the same bone
Ket: Medic slang for ketamine. Ketamine can be used as a painkiller if managed very carefully, but can also cause very vivid hallucinations and coma.
Diazepam: Multipurpose sedative.
Haematemesis: Vomiting blood, except when mixed with stomach acid, blood turns lumpy and black-brown.
GI: Gastrointestinal. Relating to the stomach or intestines.
Xylazine: A strong, fast acting sedative
Midazolam: Very similar to diazepam