Page 19 of Paging Dr. Breakup
Calvin rifled through the laceration tray and ripped open the chlorhexidine swab packets. He called over his shoulder, “Any issue with me scrubbing the hell out of this area?”
Dr. Yang nodded. “Scrub away. You’ve got plenty of time. Besides, the IV antibiotics will take care of any remaining bacteria before this patient reaches Fairbanks.”
“I don’t feel like I have time, Doc.”
“You could keep that tourniquet on for hours or more, if you had to. There’s some collateral blood flow to the leg from the profunda femoral artery, which doesn’t look like it was torn.”
Calvin grunted agreement. “Do we have an updated set of vitals?” He cleaned the surgical site and the surrounding area, smearing blood and cleaning solution with the sponge on an applicator stick.
Tom hit some buttons on the monitor. “Pressure ninety over fifty. Pulse one twenty. O2 sat ninety-four percent.”
“ETA on blood products,” Calvin asked.
The unit coordinator murmured into the phone, “Five more minutes for two crossmatched units.”
Clyde held up two bags. “Or you can use these O negatives right now.”
“Dr. Yang?” Calvin glanced up at the camera.
“I think we’re okay to wait for typed blood. Believe it or not, you really do have some time to work with.”
Clyde called out, “I’ll hang the crossmatched blood when it gets here.”
Calvin looked at Deirdre. “Are you ready?”
Her hands shook. Her heart drummed in her chest. But by God, if Calvin needed her help, she was going to do whatever it took to help him save Tuli’s life. “Yes.” She draped the field with sterile towels Clyde partially unwrapped for her to pluck from the packaging.
Amberlyn returned another few minutes later with more materials. “Got the extra equipment.” With loud crackles of sterile wrapping, she opened the packs and dropped the metal devices onto the tray.
Dr. Yang peered at the screen. “Cal, go ahead and start like you would for a vascular cut-down procedure. Make it a generous incision. Give yourself some extra room to operate.”
“Thanks.” Calvin’s neck muscles flexed as he worked. His lower face was covered by the mask. “Then use the Weitlaner to visualize the vessel for clamping?”
“Yes, basically. Your first job is to get as much exposure as possible. Don’t be shy about extending farther than you think you need to go. You need to see both ends of that cut artery.”
Deirdre gulped in the now-silent room as Calvin tried to place the retractor into the small puncture opening. It didn’t fit. He shook his head, then took the number ten blade and extended the area several more centimeters down and up from the injury. The extra space allowed him to insert the self-retaining retractor.
Despite the tourniquet, fresh blood oozed, and Deirdre dabbed with gauze. Her back-aching position leaning over the bed was OSHA nonstandard for workplace ergonomics. No way would she complain, given the situation.
Clyde adjusted the overhead light then stepped back.
The only sound was that of the ventilator’s regular whoosh and click.
Deirdre glimpsed the damaged femoral artery as she swiped away more blood. It was a thick-walled vessel with ragged edges torn completely apart and leaking blood. “I see it!”
“Good job,” Calvin murmured, his praise creating a different warmth in her chest.
Dr. Yang said, “Try to get that proximal femoral artery with a vascular clamp.”
Calvin tried, but he had an awkward angle. “Deirdre, can you get it from your side?”
“Yes, I think. I can. Hold on a moment…” A dull metal click sounded as she carefully locked the clamp around the artery. “There. How’s that look?”
Calvin flashed a smile at her. “You’re hired. Let’s do the same with the distal artery.” He locked the ratchets of the second vascular clamp with a metal clink. “Both are in place.”
Deirdre paused. What if they fixed the damaged vessel but Tuli lost function of his leg? Or got an infection? Or required amputation? A wave of panic rushed up from the depths of her belly.
No, Deirdre wouldn’t think beyond fixing the present injury.
