Two more helicopters filled the air and made Danni feel a little relief at the thought of getting them all to the care of an awaiting Trauma Team. There was only so much that she and Garrett could do in the field and right now, their resources were stretched to the limit. The nurse met the incoming Flight Crews and directed the patient flow out of the scene as deemed by the surgeon. Within minutes, the two packaged patients were loaded into the helicopters and on their way to definitive care. Danni turned around to find out where Garrett was and headed for her.
The surgeon stood over a young woman who had been closest to the point of impact. The patient’s shallow, gasping breaths were a sure sign of fractured ribs. Garrett’s concern for her breathing and the fact that the impact had already broken bones, made her more worried of the possible spinal involvement, too. It was certain that this patient needed to be flown out next.
The surgeon looked over her shoulder as Danni approached. "This one goes next," she directed the nurse. Garrett watched as her team member nodded in understanding.
The nurse turned her eyes to the heavens and looked for the next helicopter to start its descent. Knowing that it would be a few minutes for it to land, Danni turned her attention back to the patient and monitored her condition.
"GAR!" The cry came out as the nurse lifted her stethoscope from the patient’s chest. "Her pneumothorax is getting bigger by the minute. I think she needs a chest tube fast."
The surgeon’s attention was split now. "Danni, we don’t have that ability out here. Besides," Garrett looked up from the patient that she was getting ready to intubate, "I’m needed here first. You’ll have to needle it and use the tip of a glove for a flutter valve."
"But I’ve never…"
"You’ve watched me do it a couple of times. I’ll talk you through it. You’ll do just fine."
The nurse nodded her head. "Okay, I’ll try."
"You’ll do it." The order was given in no uncertain terms. "Now get an 18 gauge needle and cut off the finger of a glove. Insert the needle down through the tip of the glove."
"Okay, done."
"Now find the fourth intercostal space on the effected side of the chest." The surgeon paused until Danni had found it. "Give me some suction here. You got that tube ready?" She asked the ambulance member that was assisting her in the intubation.
"Did you find it, Danni?"
"Yeah, found it."
"Good, now pass the needle just over top of the rib and insert it into the chest wall at the midline of that side, parallel with the nipple." She picked up the laryngoscope and opened it. "You’ll know that you’re deep enough when you hear the trapped air escaping out of the make shift flutter valve." Inserting the tube into the mouth of the patient that she was working on, she continued to guide her team member. "Once you’ve got it in place, tape it down."
Danni offered up a prayer on both her and the patient’s behalf and did what she was told. "PHSSSSSSSSST!" The rush of air escaped and she breathed a sigh of relief. "Got it, Gar."
"Good, I knew you could do it." The surgeon pulled back the stylet as she held the endotube in place. "Now secure it." She directed to both Danni and her help mate in the intubation. "Give her a minute and she should be breathing easier." Garrett looked over to the nurse and beamed with pride in the woman, then resumed her ministrations to the patient before her.
Danni smiled with confidence at what she had done. It was just one more time that proved how well the surgeon and the nurse worked together.
Now, with their patients handed off to the next two Flight Crews, Garrett and Danni pushed on to the last two remaining teens. Their injuries were not that devastating but the emotional drama that they had been witnesses to was taking its toll. The surgeon assessed their physical conditions while Danni took care of the emotional support that they needed.
It absolutely tore at the young nurse’s heart to see the effect of emotional carnage that the one young man was displaying. His wild-eyed, frenzied look was enough to show that this night would be forever locked in his memory to haunt him when he would least expect it.
Danni sat next to him and held his hand, talking to him and comforting him as only she could do. Healing was not always done with medicine, especially when it came to the emotions of trauma. It took a while, but her soft voice and concern for him and his friends soon soothed the young man enough to allow him to be loaded on the next helicopter and transported to where his friends had been taken.
Garrett, on the other hand, had been plagued by the non-stop questioning of the teenager in her care. His constant need to know what happened only attested to his evident head injury, along with his being amnesic to the event of the crash. The surgeon maintained an even keel in her attitude for the first one hundred times that she heard the same question. It was somewhere during the second hundred times that her level of irritation became noticeable. That was just about the time that Danni came to her rescue having handed her patient over to the first arriving Flight Crew.
"I’ll take care of him, Gar. Why don’t you go check out the one in the car?" The nurse motioned to the overturned car that the rescue people were working on.
"Thanks, Danni." The surgeon looked relieved as she got up and started to walk toward the ongoing rescue attempt.
Just as she made it to the outer circle of rescuers, the lifeless body of the driver was released from the car. His injuries were numerous and his skin had already taken on that ashen-gray look of death. Once Garrett was able to look down at his body, she knew the outcome of the night. The odd angulation of his neck and the indentation on the top of his head said it all. The only thing he could have possibly been was an organ donor and even now, that was too late.
The surgeon knelt down next to the body and listened for signs of life. No breathing was heard and no pulse was felt as she reached for the carotid artery in his neck. Out of habit, Garrett looked at her watch and pronounced his time of death. "0138."
The night had slowly edged into the wee hours of morning as the last patient was being loaded onto their helicopter. Danni and Garrett had triaged, shipped off the earlier patients, and were now on their way into the Trauma Center with the last one. It would be their last patient together.
The limo driver was resting as comfortably as could be expected with a badly fractured ankle and wrist as the nurse and surgeon watched over him. Each one was thinking of the scene that they had just left.
Danni willed the trip to take forever as she didn’t want it to end. Stealing glances in the surgeon’s direction as best she could, the nurse wanted to freeze time and keep her team together. But as the saying goes, all good things must end. And so, as Cowboy started his steady descent to the helipad below, the petite blonde found her eyes to be misty with a veil of tears. Blinking rapidly, she fought to hide them from the others onboard.