Second day on station, first day on call, first trauma casualty of his new posting.
Fletcher had showered and scrubbed and had sat at the morning briefing where assignments had been issued and another physician and himself had been introduced. With a cup of Hot Chocolate in hand he examined the surgical suite & equipment, emergency equipment, and medications all first rate just as he'd been told by Head of Star Fleet Medical. He turned when a nurse entered the suite, and announced, "Doctor Fletcher, there's been an accident in space dock. They are beaming the three wounded here in two minutes. Dr. Cherrin wanted you as one is reported being a crushing spinal injury." Fletcher looked around the room one last time and followed the young man out to the main triage area.
He waved the nurse off who attempted to hand him a medical tricorder as the first two patients arrived with one of the paramedical staff. He listened to the paramedic's report on the first unconscious patient who had an obvious broken leg, lacerations, and shock. The second patient had what appeared to be burns and lacerations. "Where's the third patient?"
The paramedic paused before requesting transporter lock and return to scene. "The crews were still extricating that patient from the debris. When I was still on scene the trapped crewmen was still conscious but had reported no feeling from mid chest." She saw the doctor nod and beamed back to space dock.
Dr. Cherrin supervised a group of about ten staff members who were divided around the two patients. Dr. Fletcher watched the bio scans of the two patients and saw that the leg would need surgical intervention but was not emergent.
Dr. Fletcher tapped his combadge. <Dr. Fletcher to Paramedic Ensign Nacine.>
<Ensign Nacine, here.> In the background loaders, cutting lasers, and multiple voices could be heard.
<Status report on Patient three.> He asked watching Dr. Cherrin use a dermal generator on the lacerations.
<Not good, sir! We just got him un-trapped and he just full arrested.>
<Dr. Fletcher to Emergency Transporter lock on to patient three and team and beam to surgical suite!> Fletcher turned, grabbed to senior nurses and headed to the surgical suite. He scrubbed while he waited and they set up infusions and emergency resuscitation drugs. Two minutes later the patient and team arrived--CPR in progress. One of the paramedics had been about to field intubate the patient when they locked on...without missing a beat he resumed and secured the airway.
One of the senior nurses slipped in and got the safety gear and clothing out of the field. Another member pushed medications and announced, "We have a rhythm and blood pressure." Dr. Fletcher stepped in and watched the initial biometrics and system scans appear on the main monitor... T3-L6 fractures. Cord compression in two areas, and a massive busted pelvis.
"Prone him. We'll work on the spinal injuries and if he remains stable we can see what we can do about the pelvis fracture." He watched while the paramedics and nurses placed the patient face down on the biobed, and slid the surgical canopy into place. The back was irradiated and opened in a standard fashion. Dr. Fletcher monitored and manipulated the controls and started easing the bone fragments away from the undamaged cord. Two tech's had finished placing 'twitch monitors' on the four extremities. "Give a 50 mg bolus of Metropan; followed by an infusion of 2mg/kg." Two hours later he'd finished with graphing and fusing most of the damage. There was one section of cord which was minimally responsive to stimuli and he was going to have to regenerate neural tissue to graft to the cord to give this man back full range of motion, but that was going to take 24 hrs.
"Doctor, vital signs are becoming unstable,"the nurse on the opposite side said. She looked at the operation time on the surgical console- 5hrs, 29 minutes.
"Kay, I've got neural stem cells to replicate. Lets close up." When he finished he stood away from the biobed and watched while the staff transferred him to a standard biobed. "I want him to stay sedated, prone, and on the infusion until tomorrow 1100hrs, when we'll go back in and finish the spinal cord repair and the pelvis." He looked up at the clock and headed for the medical science lab and started processing the cells stimulating growth. He grabbed a quick meal replacement bar from the replicator in the staff lounge and followed that up with a liter of water and walked out to check on the other two trauma patients. Both were sleeping but after a quick check of the charts he saw that Dr. Barnes had used a tissue regenerator on the broken leg and had prescribed Metropan and Meperidine HCL. Both tech's were looking at another two or three days before release to light duty.
He refilled his water bottle and before checking out with the desk on call. He'd heard about the Marine detachment on station and that they had a medical unit. But when checking the computer he was told the senior officer for the unit was unavailable. He wandered around the promenade until he found Harry's. He entered and took a seat away from the gaming tables, ordered and ate his meal as he watched the people move around on the promenade. When finished he walked back to med lab and checked on the neural tissue, checked on his patient, then turned in for the night.
The next day he and another nurse finished the graph to the spinal cord without having to add Neural Transducers to artificially mimic the spinal cord. They finished with the repairs to the pelvis but kept the patient sedated for another 24hrs then would allow him to waken and start physical therapy.