Triage

Posted on 21 Jun 2024 @ 8:45am by Commodore Harvey Geisler & Lieutenant Commander Kennedy Monroe M.D. & Lieutenant T’Mari Rael & Ensign (Provisional) Bertrim Wysocki & Lieutenant Lucas Abrams M.D. & Lieutenant JG Daniella Blake & Lieutenant JG Harleigh Kane
Edited on on 07 Jul 2024 @ 12:04am

3,042 words; about a 15 minute read

Mission: Shattered Unity
Location: USS Black Hawk || Sickbay
Timeline: June 19, 2390 || 0900 hours

"Bridge to sickbay," Harvey called out. "Doctor, we're going to have more wounded. Standby to receive."

"Acknowledged," Kennedy replied simply. When the comm channel closed, she simply nodded to her team leads. They knew what to do and although she was still somewhat new to them, she had read prior performance reviews and had an idea of what they were capable of. Monroe was not the type to bark orders just because she could.

Upon hearing the Captain, Dani jumped into action, preparing supplies and getting a triage area set up with the help of some of the other personnel. This wasn't the first time she'd been in this type of situation. In fact, there was a time things were so bad that she had to chase their Commanding Officer down to treat some pretty gruesome wounds.

Triage was set up into three groups. The first was for critical... those needing surgeries, procedures or other treatments to save their lives. They would need tending to first. Next was for serious, but stable patients. Those that might require a bit more invasive treatments, but weren't in jeopardy of losing their lives if they needed to wait, and could be kept comfortable. Then, lastly was basic for those who might need a broken bone set, a laceration taken care of, or just needed to be looked over before being put to work to help care for the others.

While there was hustle happening in main sickbay, Lucas was busy getting his operating room prepped. When Captain Geisler came over the comm speaking of injuries, action needed to be taken. Especially, when it was unknown how many people they would be seeing.

Satisfied that all seemed to be in hand, Kennedy tapped her combadge. "Monroe to T'Mari. Please report to sickbay."

“If you’re looking for the Counsellor she’s with the away team” the young nurse offered a brief smile. “I know because I already checked. Is there anything I can do?”

Chagrined, Kennedy replied, "I was going to ask the counselor to attend to those in the two less critical triage groups. In particular, I was hoping she could attend to any signs of emotional distress for people in those groups. I've seen what emotional trauma can do not just psychologically to injured bodies, but also physically. We'd be remiss in thinking offering simple things like blankets and warm drinks are a luxury, as I don't want anyone to decompensate."

“I understand” the young woman nodded. “I’m not a Counsellor, but I am an empath. I’ll do what I can for people, it’s what I was trained to do.” She smiled. “I’m Hope by the way.”

"Thank you," Kennedy offered. "Make sure you give yourself breaks as well. There's going to be a lot of intense emotion coming at you and there's no shame in needing to step away. If you need anything, just give me a shout."

An alarm sounded from the overhead speakers. "Inbound transport," announced the transporter chief. Then, seconds later, five severely wounded patients transported directly onto biobeds, along with a nurse from the Gaittithe.

"Who's the doctor!?" cried out the nurse. "We have two aortic breaches, one with severe plasma burns, and two in synaptic shock."

Kennedy reached for her combadge and calmly announced, "Dr. Abrams, I have two patients coming your way, both aortic breaches in need of immediate repair. One's in neurogenic shock and the other has severe plasma burns." Even as she spoke, Monroe was initiating transport to the surgical ward. Ideally, Kennedy would've liked to stabilize both patients before sending them to surgery, but in this case, if the aortic rupture wasn't addressed immediately, both patients would bleed out before the other injuries could matter.


***

Lucas tapped his combadge. "We're ready for them," the large man stated as the last of their preparations were made.

The two severe cases materialized in the surgical ward. The one in neurogenic shock just laid there, eyes rolling into the back of her head. The one burned almost beyond recognition twitched with each breath, moaning in pain.

Harleigh had suited up as much as one could for a traumatic medical emergency and joined their resident surgeon. "Neurogenic shock," she stated, after checking her tricorder. "Heart rate, blood pressure, and temperature are low. We have to stabilize the head and neck for a spinal injury." She quickly moved to the burn victim. "Antibiotics, fluids, and pain management," she said pointing to the hyposprays. "As much as, and if, possible."

She turned to the giant of a man. "May I recommend the spinal injury first, Doctor Abrams?" Harleigh was no surgeon. And triaging the worst cases from the initial triage was daunting enough. Lucas was not only her superior officer, but the chief surgeon as far as she was concerned.

"Yes, you may, but there's no reason anyone needs to wait. Tell Dr. Monroe to activate the EMH," the large man said as he moved to the patient he would be treating. "If she has questions, I will answer them afterwards."

"Understood, Sir," she answered. She tapped her commbadge and passed along Doctor Abrams' message to activate the EMH for assistance. She honestly was glad that she wouldn't be there when he came online...gave her the creeps.

Three meters away from Doctor Lucas, the EMH shimmered into existence. "Please state the nature of the medical emergency." The hologram blinked and took a look at what was in front of him. "Don't tell me. Surgery."

"Multiple," Lucas answered as he began stabilizing his current patient. "More than I can manage on my own at the moment, which is why you're presence has been requested. Severe burn victim..." He nodded to the unconscious patient that was currently being given pain meds and fluids, then to the third that was also being tended to by his surgical staff. "and neurogenic shock."

"Very well," muttered the EMH, stepping up to the patient without a surgeon. He picked up a tricorder and performed a scan himself to appraise himself. "Is there a spare nurse? I need 20ccs Neurozine, Kelotane, and a protodynoplaser."

Harleigh squealed and jumped a little when the EMH appeared in the surgical sweet. She had not been expecting that at all. "There's a spare something," she said as she grabbed the items listed off. She handed the Neurozine first. "All in the order you requested."

"Good," the EMH said, immediately putting the hypospray to work. "Do you have time to assist with applying the gel, or does the body builder over there need you?"

Lucas glanced toward the EMH after briefly pausing his current task. "She can assist," he said, turning back to his own patient.

"Good," the EMH stated. He looked at the nurse and nodded at the jar of Kelotane. "Apply the gel to critical portions only. Don't let the burns allow joints, eyelids and other vulnerable areas to stick together and fuse. I'll use the protodynoplaser to work on the the worst areas and close the wounds. Goal is to stop the bleeding, downgrade his condition, and get the bed free for a new critical case."

"Yep," said Harleigh, reaching for the jar. She began to apply the gel to the critical areas. There were lots of critical areas. She shook her head and put the jar down when she finished. It was going to be a long day.


* * *

Seeing there were still three patients in need of attention, Monroe whipped her tricorder out. To the panicked nurse that had just arrived, Monroe offered, "I'm Dr. Kennedy Monroe. What can you tell me about the other three patients?" Scans could tell her a lot, but it always helped to hear more about the mechanism of injury.

"This one is in synaptic shock," said the medic, gesturing to the Vulcan at the furthest end. "The Andorian lost both antennae and has a collapsed lung. And the Risian took a half dozen pieces of shrapnel in her chest. I think there's a piece lodged in each lung."

Hope gave a horrified look everyone was busy except her, she wasn’t trained to be a surgeon and right now that’s what they needed. “I’m...not a surgeon, I can’t..”

The medic handed the woman a hypospray. "You can numb their pain. No more than 20cc for the Andorian and 10 for the Risian. The surgical ward is already full. We have to keep these two alive until surgery's ready."

Hope nodded. “That I can do.” She took the hypospray heeding the medic’s words in how much she administered to the patients.

Kennedy nodded her thanks to the medic and moved on. She had to trust her team to do what they needed to do without micro-managing. "You've got this, Hope."

Satisfied the initial wave was being tended to, Kennedy scanned the area. It was chaotic, but so far, controlled, although Monroe knew she couldn't get complacent. This was only the beginning. As if on cue, she watched the next wave come through and she offered firm but reassuring directives to help ensure the variety of spaces were being used efficienty.

"No! Don't do that!" The sound of the anguished nurse pierced through the din and Kennedy looked up to see a man collapsed against a biobed, blood spurting from a forearm where he had inadvisedly removed shrapnel in a panic. The man still clutched the shrapnel in the other hand and had thankfully stopped resisting help, but the nurse was quickly losing her grip on him as blood loss was making consciousness a distant memory.

Kennedy rushed forward and struggled with the nurse to get him onto the biobed, then quickly set about controlling the bleeding. Though understandable, it was hard to see people make their injuries worse.

A chime sounded from the comm system. "Transporter Room to Sickbay. Five wounded incoming from an escape pod."

"Acknowledged," Kennedy replied calmly, her tone giving no indication of the adrenaline surging through her. No matter how many times she had faced similar situations, the rush never seemed to leave her. The minute it did was the moment she knew it would be time to stop practicing.

Monroe quickly finished up with the hemostatic field regenerator on her current patient's shrapnel wound, allowing the emitted field to promote rapid coagulation before she then quickly turned her attention to applying the vascular regenerator to seal damaged blood vessels and restore normal blood flow. She didn't particularly like leaving any patients care unfinished, but under the circumstances, she knew she had to mentally and physically shift gears, leaving others to clean and debride the wound before closing it with a dermal regenerator. Such steps were still important to preserve the man's life, but it was also the steps, big and small, that she had to trust her team would take care of without her.

The wounded materialized in the middle of the room. Two exhibited features of broken limbs. One had a terrible gash above an eye that a makeshift bandage was not stopping. Another crewmember was missing an arm, and the final arrival appeared to be shaking and very pale.

With practiced ease, the medical team moved swiftly to attend to the latest wave, Kennedy at the fore, her tricorder out and scanning just a second or two after her eyes began to assess what they were dealing with. While it was true their equipment could tell them a lot about the nature of injuries or illnesses, especially things that couldn't be determined with the naked eye, any experienced medical professional understood it was unwise to rely solely on scanners when it came to making medical judgments. Kennedy believed that medicine was as much an art as it was a science, and even if she couldn't quite find the words to immediately articulate the reasons for making certain decisions, she would never dismiss gut feelings or intuition in the process.

Even so, advanced medical equipment made decisions easier when the heightened stress of the situation could lead to second-guessing. Any injury, at first glance, could be deemed minor when in fact symptoms could be hiding a lurking danger.

In this case, the patient with the missing limb was the obvious immediate priority, and Kennedy quickly turned her attention to using the hemostatic field regenerator to control the bleeding even as she gestured to members of her team to assist her and tend to the other people in distress.

Anyone with obvious uncontrolled bleeding had to take priority, but Kennedy knew she couldn't afford to assume the patient that was shaking and quite pale could wait. Shock, depending on its cause - which could be anything from psychological trauma, love lost, or some other serious underlying medical condition - was nothing to be ignored, and neither were broken bones, which could result in infection and nerve damage if left untreated.

She was thankful she didn't have to deal with all of this alone.

The transport alarm sounded again and this time when the columns of blue light had finished depositing the wounded. Of the seven new arrivals, five had minor injuries. A sixth, an Andorian, was missing both antennae and sported several lacerations on his face. The seventh, a Tellarite, was barely recognizable thanks to several burns and cuts.

Dani rushed toward the newcomers, quickly assessing the situation. She sent those with minor injuries to be quickly treated, and hopefully, turned loose to help with the steady influx of people coming in to be treated. Stabilizing them was priority, and given their current situation, she needed a quick consult with Kennedy for orders. "Doctor Monroe... two patients... one species currently unknown with severe burns to a great deal of the body and various cuts, and an Andorian with severe trauma to antenna and multiple facial lacerations."

Kennedy didn't hesitate. "Tend to the Andorian, please.Administer 10 ccs of Bicaridine for pain, and then you can focus on controlling the bleeding and tending to the trauma to the antennae." Both patients had serious injuries, but Kennedy understood under these circumstances, the patient with severe burns was the most critical, and that was why she would attend to that patient herself. An Andorian's antenae were critical for processing sensory information and expressing emotion, and Monroe didn't wish that kind of damage on anyone, but she also knew the patient could still survive with damaged or even absent antenna and she had hope the damage could quickly be repaired with the help of a tissue regenerator and a neurostimulator if necessary.

Dani nodded her head and began to treat her Andorian patient per the doctor's instructions. It had been a while since sickbay had seen this kind of traffic, and really hoped it would be a long time before it happened again.

Monroe then set her sights on treating their burn patient. She hoped taking a sample of DNA would help to identify the patient's species as quickly as possible because without more information, she could end up killing the patient with any decision she made using something seemingly harmless as a hypospray full of af painkiller.

Ensign Wysocki finally made it down to Sickbay. He carried his Starfleet Academy-issued field first aid kit in hand with his tricorder on his belt already. The place was swarming with wounded whether they were in Starfleet uniform or civilian clothing. The smell was offputting, something he had been warned about in class but never experienced firsthand. He kneeled down and then pulled his tricorder in front of another Ensign who he had recognized in the graduating class from 2389. He pressed the scan button to get their vitals, "Broken humerus, scattered ulna. Contrusions up and down. I'll need an osteogenic stimulator..."

Woyskici snapped the tricorder shut and returned it to his belt. He brought his kit over and looked for it. He found a dermal regenerator and put that aside but couldn't find one in his kit.

"You're Socks, right? From the Academy?" The ensign tried to look at the fellow Ensign before him quizically but he was not able to focus due to the pain, "can you do something for the pain?"

"I can give you a mild analgesic that's all I'm allowed to give you. It may not help you fully with the pain you're experiencing but it will give you some mild relief."

Wysocki looked over the chart and then filled the hypospray placing it on top of the arm and pressing the injection button. He returned the hypo and the ensign he was treating looked slightly relieved from the pain. He looked around to see if any of the medical personnel were available for him to request a osteogenic stimulator. Then he looked down and the instrument was right there. He picked it up and started to hover over the Ensign's arm.

The comm system chimed in the busy sickbay, which somehow was loud enough to be heard over all of the commotion. "Flight Deck to Sickbay. We're about to receive four shuttles filled with survivors. Looks like about fifty people, and there's a wide array of injuries."

Internally, Kennedy allowed herself an exhale, but externally, she continued to treat the unidentified burn survivor with one hand while she reached up to tap the intercom with the other. "Acknowledged, Flight Deck. We are ready." She tapped her badge and opened an internal channel to her team. "More incoming, gang. About 50 patients with varying injuries. Keep up the great work and drinks are on me when we're through this."

"Do we even have room for fifty more patients in here?" asked a nearby medic, tending to a new arrival whose leg had seemingly been sliced open by a ton of shrapnel. The medic wasn't wrong as the Black Hawk's medical complex was already hitting its maximum capacity.

"We'll put them in the corridors on grav-stretchers if we have to," Kennedy replied, "but in the meantime, let's try to discharge as many people as we can to quarters. We can monitor them remotely."

Kennedy didn't have time to wait for a response, but the one thing she knew for certain was this too would pass.

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