Page 18 of Paging Dr. Breakup
“If our CRNA rolls in here soon, you can take a nap.”
“Sure, tempt me with the good drugs.” Tuli’s speech slurred. “Hoo, boy. I don’t feel so good.” His eyes rolled back, and his head lolled to one side. Out.
“Repeat vitals now,” Calvin said, so calmly. Too calm. He glanced over to the unit coordinator. “Do we have Fairbanks yet?”
The woman held out the phone. “I’ve got Dr. Yang on the line. She’s on call for trauma surgery.”
“Put her on speaker.” Calvin projected his voice toward the phone that the coordinator placed in the nearby vitals machine basket. “Hey, this is Cal Garrett, ED doc out here in Yukon Valley. We’ve got a femoral artery puncture, snowmachine rider versus sharp object. Unstable vitals. No surgeon and no ability to transfer for at least twenty-four hours. This facility doesn’t have enough blood products to stay ahead of the hemorrhaging.”
“Sounds like you need to do a femoral artery repair.”
“That’s where you come in,” Calvin said.
After one crisp chuckle, Dr. Yang got down to business. “With the right tools, you can fix most anything anywhere. It might be a little messy.” She paused. “You’re going to do great. Can we establish a proper telehealth link so I can see what you’re doing?”
The coordinator and Clyde rolled in the telehealth video console and set up the connection.
Sweat rolled down Deirdre’s back. This room was getting more crowded by the minute.
Calvin tilted his chin. “Thanks, Dr. Yang. This isn’t a situation I personally encountered at Harborview, due to having ample operating room availability and acute care surgeons always in-house.”
The trauma surgeon adjusted the camera remotely, so it angled toward Tuli. She peered at her screen. “This is par for the course for remote Alaska sites. I walked a family doctor through an appendectomy in Kotzebue a while back. Yours will not be the first assist I’ve performed from hundreds of miles away.”
“Glad you’re confident.” Calvin grimaced. “Deirdre, can you help?”
“Yes.” If he was going to attempt to save Tuli’s life and limb, then she would do her best to assist him. Her mouth dry, she gulped, donned a mask and eye shields, then shrugged into a sterile gown, cuffing on fresh gloves.
With the tourniquet in place, the bleeding from the open puncture wound had slowed to a trickle.
Tuli’s right leg blanched.
Minimal blood flow to the limb. How long could that go on without causing damage? She didn’t know.
The CRNA, Tom, arrived out of breath and already banging open drawers on the ED anesthesia cart he had dragged behind him into the room. “What can I do?”
Calvin answered while shucking off his bloody Patagonia vest and donning a sterile gown and gloves. “Twenty-eight-year-old, no known medical conditions or allergies, traumatic puncture to the femoral artery. Passed out from large volume blood loss. I’m about to do a vascular repair. Can you get him anesthetized so that he doesn’t wake up mid-procedure?”
If they couldn’t fix the leg, Yukon Valley did not have enough blood for the massive transfusion protocol. If this procedure didn’t work… damn it. Deirdre clenched her hands together, hoping that anyone watching would think she was simply keeping her gloves sterile.
Tom quickly pulled medicine into syringes, labeling each one and laying them in a neat row on top of his cart. He got to work pushing meds, intubating Tuli, and hooking him up to the ER ventilator.
Dr. Yang turned to talk to someone off screen. “Yes, hold my next case. I’m going to be a while.” She glanced back to the scene. “Do you have vascular clamps in that kit?”
“No, this is a laceration tray,” Calvin said. “Before staff runs down to the OR, are there other surgical tools you want us to use?”
Dr. Yang nodded. “At least two small vascular clamps, a small Weitlaner retractor. Suction. For suture, use 4.0 Prolene if you have it. Give a dose of Ancef because—”
“Surgeons love Ancef?” Calvin interrupted.
“You’re not wrong.” Dr. Yang gave a dry chuckle.
“I’ll be back in a sec.” Amberlyn dashed out the door, past Mav and Louise who still hovered nearby with twin worried expressions.
Clyde said, “How much Ancef do you want?”
“Two grams,” Calvin and Dr. Yang said at the same time.
In spite of her fear, Deirdre broke the tension. “Look at you, Calvin Garrett, junior surgeon. Pretty soon that will be the only antibiotic you’ll use.”
