It was only a matter of ten or fifteen minutes before the bloodstained body of the small vehicle’s driver was lowered out of the tree. The use of an aerial ladder raised to the side and above the treed vehicle afforded them the vantagepoint that they needed. They rigged their rope and pulley assembly there to lower the victim secured to the backboard down to the ground and into the waiting hands of the medical personnel. Surprisingly, the victim was alert and oriented to his plight. His anxious cries for help tore at the young nurse’s heart. It was her nature to care and comfort, not stand around, waiting for the patient to come into your reach.
"He’s going to be full of glass, Danni. You’d better make sure to have your heavier gauge gloves on." Garrett thought out loud as they stood there watching.
"Yeah, got them right here in my pocket." The petite nurse touched first her right then her left side leg pockets. "Never leave home without them." Then she began to pull them from her zippered pockets. In the process a small vial of solution started to emerge with them. ‘What the…oh, forgot I had that in there from yesterday in the E.R.’ She pushed it back into her pocket, pulled the zipper shut and stood ready for the patient as she pulled the gloves onto her hands.
Within minutes the lowered form was disconnected from the rope system and carried across the rough terrain. The group of litter bearers never stopped until they were well out of the danger zone, and the patient placed on the framework of the helicopter’s stretcher.
The rescue worker in the lead looked directly at the Flight Surgeon, his eyes pleading for help. "He’s bleeding from somewhere on his face and we just can’t get it to stop."
Garrett glanced quickly at the blood soaked clothing of the rescue personnel then to the patient himself. If something weren’t done to stop that bleeding soon, there would be little blood left to keep him alive on the inside. She caught a glance of the lone I.V. site in his left arm. The fluid chamber of the regulating gauge was dripping so fast that it was almost a steady stream.
"Danni, get another I.V. line established and hang Ringer’s Lactate wide open." The surgeon muscled her way into the group of concerned E.M.S. personnel. "Shine those lights on his face. Let’s get a look at this wound." She reached into the pile of gauze and absorbent dressings, carefully lifting them from his face.
Garrett grabbed the offered gauze from the Medic’s hand and used it to try to wipe some of the blood from the patient’s face. As fast as she blotted the area, more blood appeared. It seemed to be gushing out of his very pores, all concentrating in the area around the right eye. After a few more handfuls of fresh gauze, it appeared that she was making a little headway. The long jelly-like masses of coagulated blood clung to the gauze like a baby to its mother’s nipple. Now, the injury could be seen much clearer.
Danni noticed the quietness at once as the voices around her halted. She looked up from her ministrations with the I.V. tubing to see several shocked faces on the rescuers. "What’s wrong?"
Her question was meet only briefly by the blue eyes of the Flight Surgeon as Garrett looked up from the brutalized flesh, then, continued examining the right side of the patient’s face.
The nurse looked directly at the traumatized patient’s face. Even from where she stood an arm length away, the injury was horrendous. The right eye was protruding from its socket and grossly misshapen. There wouldn’t be much that they could do for that eye now. Stopping the bleeding was their major concern. Knowing that head wounds have a tendency to bleed more due to the vascular nature of the body, Danni was not appalled by the site like many of the rescuers were. She just kept moving along about her job.
"Artery?"
Garrett shook her head. "No, the blood just keeps coming from that whole area." She blotted the raw flesh again trying to see it better. "Danni, we don’t carry Lidocaine with Epinephrine in our drug bag, do we?"
The nurse handed the bag of I.V. solution for a rescuer to hold. "I.V.’s in and running wide open. Lidocaine with Epi, not likely. They only use that in Plastic Surgery." She moved out of her position and joined Garrett at the head of the patient. "We don’t carry that in our bag," she smiled as she remembered the vial in her leg pocket, "but I know where we can get some."
Danni quickly produced the vial from her pocket. "Would 20cc be enough?"
She held the bottle up with the label facing the surgeon.
The lopsided grin spread like a bolt of lightning across Garrett’s face. "Yes, that just might be enough." Her eyes twinkling with delight at the sight of the drug she needed. "Get me a syringe and a few needles, 25 gauge if you have them. Were going to use an old plastic surgery trick to stop this blood loss."
With needles and syringes procured, the Flight Team worked to arrest the bleeding by injecting small amounts of the drug under the skin. It was a way of keeping the very vascular regions of the face that were filled with multitudes of capillaries, small veins and arterioles from bleeding while the plastic surgeon would do the tedious job of stitching up any lacerations through the layers of nerve sensitive tissue. It would allow plastic surgeons a lengthier time to work at the tiny hair-fine stitches that were necessary. Garrett finished the last of the injections, using up the last of the drug. "There, that should give us a chance to get him to the Trauma Center and replace some of his blood." She straightened up and rolled her shoulders trying to release the kink that was forming already. "What’s his pressure now?"
The medic took another reading while the surgeon studied the exposed globe and placed moist gauze then the domed plastic shield over it for the protection of the once sighted organ.
"BP is 100 over 76, Heart Rate is 108, and Respirations are 24."
"Okay, let’s get him loaded for transport, there’s nothing more that we can do here."
The Flight Surgeon’s words were like gold taken at face value. The group of rescuers hastily carried the helicopter litter into the receiving door as Danni slipped inside the craft to direct the stretcher into place and lock it down. The surgeon brought up the rear, as she gathered the equipment bags, bringing them with her. Once the bags were stowed inside, Garrett slid the compartment’s door closed, locking it in place. She promptly took her seat and buckled herself in for the ride. A quick visual check assured her that Danni was in place and ready for flight. Garrett gave the thumbs up sign to the pilot and they were on their way.
The sound of the whirring blades picking up both speed and power for lift off were a welcome noise. It would mean that they were at best, only twelve to fifteen minutes from the hospital and an awaiting ophthalmologist to whisk him into surgery. That was, if there was any hope to save the eye.
The surgeon continued on with her secondary assessment of as much of the patient as she could reach while Danni monitored his vital signs. With the abbreviated survey giving her no additional speculations of injury, the surgeon called in her report. With that out of the way, the Flight Team settled into their seats and waited for the familiar sights of the City of Pittsburgh to come into view.
"Danni," the soft voice of the surgeon could be heard over the helmet radio, "that was a nice assist back there. Where did you come up with that Lidocaine with Epi?"
The nurse shrugged her shoulders rather tiredly. "Sometimes it pays to help out in the E.R. when we’re waiting to be called out. I was assisting the Maxillo-Facial Surgical Resident yesterday and just happened to pick up an extra vial." She let the smile spread across her face, content in the thought that she had everything that Garrett could possibly want.