Day 2: Triage


By the end of the first day, Chief Petty Officer Kaaran and his team had managed to get the colony's warp core back online and restored power to what was left of the comm's grid, among other things. He shut down the automated distress call and replaced it with an emergency broadcast, telling any survivors to make their way to a shopping mall in downtown Aylos. It was the largest surviving structure left in the city, so it would be the best place to set up our field hospital.

I spent nearly three hours in the sonic shower back on the Kitty Hawk trying to get the ash out of my hair, to no avail. I tried every kind of shampoo I could think of, but nothing was working. Until Kitty showed up in my bathroom.

"I went over like, thirty thousand medical textbooks. But I figured it out. Just pour some Vodka into a spray bottle, mix it with water, and presto! No more ash!"

"You can't be serious," I said to her, still clinging to my towel. But she insisted, so I replicated a bottle of Smirnoff, drank about half of it, mixed the rest into the spray bottle… and by every God that a reporter prays to, it worked.

After I finished drying off, I went to join the next team that would be heading down to Aylos. Dr. Julian Mendez is a classical, handsome gentleman. In truth, dear reader, if this wasn't a disaster, I might have been tempted to ask him to spray the vodka on me in the shower. Julian comes from El Salvadore on Earth, from a fairly distinguished family of doctors, surgeons, trauma specialists, that sort of thing. While Julian's sisters took CMO positions on different starships, Julian told me wanted to 'see some action chika,' (his words, not mine) and stayed on Earth, instead joining Fed-Sec's EMS (Emergency Medical Service) division right out of Med School.

EMS should be the most familiar Fed-Sec division to my non-criminal readers. Anywhere in the Federation, if you get in a shuttle accident, break your arm playing hoverball, or get brain freeze from a daiquiri next to the pool at the Intercontinental, chances are it'll be a Fed-Sec Paramedic that shows up, wearing his or her blue and white ball cap, and fixing whatever ails you. By Federation Law, all Paramedics have to operate under the medical supervision of a certified Medical Doctor. In a regular day, Julian usually sits in an office and signs off on a team of Paramedic's reports. But he likes to get his handsome, classically beautiful hands dirty (my words, not his), so more often than not, he'd be on the ambulance shuttle right along with his guys.

Our first task was to turn this mall into our field hospital. CPO Kaaran's team had worked through the night to get portable generators set up. After we beamed down, Kitty started beaming down all the stuff we'd need to set up a field hospital. Biobeds, portable scanners, medical replicators, and piles-upon-piles of IFAC and first aid kits. I helped two Paramedics set up a biobed and a big medical scanner in a dress shop on the second floor of the mall. The idea was that we'd turn this shop into a surgical bay, in case any of the wounded needed extensive surgery. After we hooked up the power to the scanners, I stopped and pulled off a red sequin cocktail dress from one of the racks.

I held it up against my dusty jacket and winked at Julian. "What do you think? Fits me alright eh?"

Julian winked back. "You look fine chika. But I got something you might like even better." He tossed me a Starfleet-issue lab coat. I'd be helping him out as his triage nurse.

For readers who aren't familiar with the term, Medical Triage is the process where medical professionals sort patients in mass-casualty events by priority of care. The goal is to prioritize the patients who have the greatest chance of recovery, spending no more than five minutes per patient to determine what colour to give them. There are five colours, each with a different meaning.

1) Blue – Resuscitation

2) Red – Emergency Surgery

3) Yellow – Urgent and life-threatening

4) Green – Urgent but non-life-threatening

5) Black – Non-urgent, dead, or no hope of recovery

Black is the hardest colour to assign. Its easy if someone's already dead, but it's the hardest thing to classify someone who's alive, someone who's breathing, as a black tag. Once the field hospital was set up, Force Recon – who'd been standing guard around the mall due to rumors of looters and violent criminals running loose in the city, started bringing in the first wounded survivors. The Marines would set a person down on a biobed or a stretcher. Julian, or another doctor, or a qualified Triage Paramedic from Fed-Sec, or even a few FMC Combat Medics, would go over to the patient, give each a quick scan with a medical tricorder, and then tell the triage nurse – me, in this case – what colour to assign and what treatment that the doctor ordered.

"Second degree burns, contusions to the head and chest, cuts to the extremities. BP 90/60, pulse 85, resps 12pm. Classify as green, move to the secondary trauma unit," Julian ordered, sounding less like a handsome gentleman and more like a well-oiled machine.

"Got it," I replied, quickly putting the notes into my PADD.

Kitty and the Starfleet Engineers had managed to set up a pretty sophisticated local network while we were setting up the field hospital. As soon as I finished putting the notes into my PADD, the orders were sent over to the trauma unit. Ten minutes later, Paramedics came in and took that patient – an 18 year old girl – to a sporting goods store that was doubling as the trauma unit. Me and Julian spent the next six hours going patient to patient. By the end of that day, 7 699 wounded civilians had been brought into our field hospital in the mall. Those 7 699 were cared for by 15 doctors, 85 PCNs (primary care nurses), 150 Fed-Sec Paramedics, and another 150 FMC Combat Medics. We got some help from the colony too. Nearly every Federation colonist nowadays has some kind of first aid or medical response training.

I personally find it inexcusable, dear reader, for anyone not to have some kind of medical training in this day and age. The basic first aid course is two days long and is offered at every community hall and rec-centre in the Federation. And think about it this way. What's the cost of two days when you weigh it to one day being able to save someone's life? The pool at the Intercontinental won't miss you for one weekend.

Me and Julian got to our last patient, an old mechanic looking after a little girl. The mechanic was the girl's grandpa. Her mom and dad were killed in the initial blast of the eruption, and Grandpa had just barely gotten himself and his Granddaughter clear, before the front half of a hovercar slammed down onto Grandpa's back.

"Please," Granddaughter said with tears and ash covering her face, "Help my grampy."

"Shh sweety, its okay," I said to her, wiping her face off with a napkin, "Your grampy's gonna be just fine."

But I was lying. Julian slammed his tricorder shut and looked at me with a sense of urgency in his classically handsome eyes. "Help me get his stretcher up. We gotta get him into surgery, stat."

Julian, Me, and an FMC Combat Medic carried the stretcher into the dress shop-turned-surgical bay. We set the stretcher down on the biobed while Julian went to work with that urgent but calm voice of his.

"This is a code blue," he explained to me, "Multiple hairline fractures down his C2 and C3 vertebrae. Ordinarily this would be a yellow case, but look at this."

He pushed the scanner over to me, showing a live digital image of the part where your neck joins with your brain, and pointed at a spot just below Grampy's left ear. "He's got a bone chip that broke off from C2 about to pierce his brain stem. If we don't get this chip out, chika, he'll be dead in about ten minutes."

"What do you want me to do?" I asked, trying to channel his urgent but calm voice.

Julian handed me his tricorder and winked. "Just follow me, Chika."

Meatball Surgery is what most Doctors call it. When a civilian like me thinks about surgery, we think about the holonovels of brave doctors in perfectly clean scrubs, doing delicate work in brightly lit surgery bays in a hospital somewhere.

Instead, me and Julian were doing meatball surgery in a dress shop on an improvised biobed, while the black sky of volcanic ash hung over us through the skylight. It was very touch-and-go. Julian rolled Grampy onto his stomach, cut the back of his neck open with a laser scalpel, and had me hold the forceps while he prepared to extract the bone chip that was minutes away from killing Grampy. We were almost there when another tremor from Aylos shook loose a hovercar outside, which cut the main cable for our field hospital. The portable generators kicked in right away, but someone (probably me) forgot to plug the lights into the generator. So, for Julian to finish the operation, I had to hold up a flashlight over Grampy's neck.

"Don't shake so much chika, I might slip," Julian said, trying to make me smile, "Breathe in through your nose for four seconds, hold for four seconds, breath out for four seconds, and hold your lungs empty for four seconds. Do that four times, and you'll be stress free in four minutes guaranteed."

It worked. My hand stopped shaking, and Julian was able to extract the bone chip out of Grampy's neck. The Combat Medic stitched him up, and now I wasn't a liar to Granddaughter. I was too tired to beam myself back up that night, so I passed out on one of the spare bio beds. Julian and his team did the same in that dress shop. Despite my skepticism, I admit that I was actually impressed. Fed-Sec, Starfleet, and the FMC had worked like a well-oiled machine. Our shopping mall field hospital – which took just over an hour to set up, saved the lives of thousands of colonists. This wasn't the bureaucratic mess I'd written about. This was a group of dedicated professionals doing what they do best. Saving lives.

One post-script. I talked Julian into buying me that red sequin cocktail dress. He promised me a date in the wild elephant reserve next to the Intercontinental. I'll let you know how it went in my next article.


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