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Chapter 31

She moved to check the next curtain to check on the next trauma after changing her gown. "What do we have?"

"Male, 55, severe burns to the right side of his body; Tibia on the left leg is exposed, Stats stable but unresponsive. " The nurse updated her while an orchestrated barrage of chaos swirled around the man.

"Ok, page ortho for the leg, and neuro for a possible head trauma for the cause of the unresponsiveness. Debride the burns and cover with moist cloth and page plastics to come and determine where to proceed next, and page me with any changes." She handed the chart off to an intern. "Kyle you're in charge of this patient, keep him alive any problems or questions find me." He nodded. "Jane, follow me we're moving on." She nodded.

"Yes, ma'am." She said slightly in admiration. She moved to go to the next patient when a car barrels past the ER doors almost hitting a paramedic and a nurse. She was about to turn when she heard a crash and screaming.

"Jane! Grab a gurney and a backboard with a C collar and meet me outside." She grabbed a ready bag from by the door for going out on scene and went out the ER doors to see what waited. What she saw before her sent chills down her spine. The car itself had hit another parked car and the driver had been expelled from the car and was lying prone on the windshield of the car that had been impacted. She only let her emotions take over for a second and then pushed them down to let the rational, medical part take over. She ran over checking the inside of the crushed car for any other survivors. She peeked in the back window in decent condition for the other damage. She shielded her eyes from the sun and gasped. The wind from her lungs rushing out in surprise, there was a car seat. It was rearfacing so for an infant.

"Oh, no!" I whispered. Jane came running up behind me with an intern. "Jane, go get vitals on the man on the car and assess his injuries. Then carefully apply the C-collar and then come update me." I turned to the intern, while jane ran to the other car. "Intern!"

"Michael ma'am."

"Don't care, sorry, I do but you need to listen closely, Malcom."

"Michael."

"Ya, that's what I said, go page pediatrics tell them we have a baby trapped in a car outside the ER and I need the attending. Have them bring a pediatric intubation kit and IV stat." He nodded and ran. A paramedic saw the accident and ran over.

"What can I do to help?" He asked.

"Lean into the passenger side window and stabilize the head while I try to open the car door. " He nods and finagles his way in there the best that he can and holds the head still. "Ok, now once the noise starts or if the baby comes to he may wake up its your job to not let him move." He nods again. "Use your words."

"Yeah, yeah, I got it. Sorry, first day on the job." She cursed under my breath. Of course, the way her day was going she would get the newbie.

"Ok, here we go." She starts pulling on the handle and it's jammed. She steps back and kicks the crease of the door a few times; she steps back in to try it again and hears the baby crying. She lets out a breath, good that's a good sign. She yanks on the handle again and it pulls free just as the pediatric attending arrives. She turns to the Paramedic. "Don't move an inch until the attending tells you to. This is her and she is the one in charge now. Stay with her until you're dismissed. I am going to help Jane with the driver." He nods eyes wide. "You did good." She put a hand on his shoulder trying not to jostle him, he was nervous enough as it was.

"Dr. Swan!" Jane yelled from the other car. Bella nodded at the young man and turned her attention to her new patient. She ran over putting her stethoscope in her ears.

"What do we have Jane." Jane was in all out survival mode. She rattled off the information quickly and in between quick breaths. This is what happened when you spent too much time in research when it wasn't your specialty. You forget things aren't prepared, and make mistakes all things she didn't need right now.

"OK, um, male I'd guess 30's blown right pupil. Deep laceration on his left leg, I'd say it's probably broken. He has multiple lacerations on his face, most likely from glass from the windshield."

"Ok, so what does all that mean? What would be the first thing you do?" She asked, trying to get her to think on her feet.

"Uh, um…I would uh, well. I would start with the head wound. He probably has swelling and it needs the pressure released. I'd page neuro and wait for them to make burr holes."

"Ok, this would count as being out on scene. No consult now what." He was circling the drain she needed to come to this conclusion faster. "Come on Jane, think!"

"Uh, ok, I need a drill." Luckily she had thought ahead to have a nurse grab one. Smashing through a windshield inevitably meant head wounds.

"Here," She said handing her the drill." She paled.

"N-no I can't." She stuttered. She looked at her and weighed her determination. She was running on fumes. This was not her normal every day and too much more would send her into shock she was afraid. She wouldn't push her anymore today.

"Fine give it to me." She took the drill and proceeded to drill holes into the man's skull. "You want to give pressure but not too much because the bone is thin and you don't want to hit the brain, but enough to make holes because it is bone after all." She finished the last of three holes. The blood oozed out and reinforcements came just in time, one of them being Edward.

His eyes searched the scene gazing over everything until they came to rest on her. She saw him take a breath. Then instincts kicked in and he rushed over.

"Dr. Swan, what do you have?" He asked her curtly. She filled him in on the patient and all that had been done just as a back board and c-collar were placed on him. He was then transferred to the gurney. He made to leave.

"How was the little girl." She asked about his earlier patient.

"Good I was able to save the leg, my fellow took over finishing the patient, last I knew she was stable." She nodded her approval of sorts.

With both patients gone and adrenaline leaving she was feeling fatigued.

"Dr. Swan." Said a small voice from behind her, she turned.

"Yes Jane?" She asked.

"May I please go change into clean scrubs." Bella finally took in her complete surroundings. The spectators, how covered in blood, and glass her and Jane were; she looked up at Jane again.

"Yes, sorry Jane. Great job, go clean up and check yourself for lacerations from the glass. I'll page you when I'm ready." She nodded and scampered off. She stripped her gloves and added it to a biohazard bag and went back into the hospital to let the police who had no arrived to figure things out. Definitely a long day.