Posted by Gamemaster Mischief Maker (co-Gamemaster) in Main Sim - Hull Breach (Emergency Response Teams)

Posted by Lieutenant Commander Alexis Kane (Assistant Chief Medical Officer) in Main Sim - Hull Breach (Emergency Response Teams)

Posted by Lieutenant Commander Drake Marshall (Surgical Chief/ Emergency Medicine) in Main Sim - Hull Breach (Emergency Response Teams)
Posted by… suppressed (31) by the Post Ghost! 👻
The klaxons went off and the announcement sounded across the ship. =/\=Emergency response teams to Decks 7, 8, 9 aft. Hull Breach.=/\= Alexis had grabbed a patient that had been knocked off balance by whatever had hit them. She passed the man off to a nurse. “Jt’nal get the surgical and ICU units prepped for severe casualties. Response teams let’s go.” She grabbed a medical kit and a rebreather, just in case, as she walked out of the door of secondary sickbay and to the starboard lift and up to deck 9. Several people stayed on the lift up to decks 8 and 7. Additional teams would be coming from Primary Sickbay and from the other departments.

Stopping at the cross section by the first shuttle bay, “Bells, cordain off this area and set up a triage area. Then we’ll move people from here.” Bells nodded and set up alerts on the LCARs panels around the area. Alexis continued around the hull and stopped before she reached the actual breach. There was no obvious openness to space. Security and engineering would sweep first and then they would go looking for injured. She gave a nod to the security officer and waited.

Lt. Cmdr. Kane, AMO

“Damn it.” Drake whispered under his breath as he heard the emergency call. He turned on his heels and looked to his surgical residents. “You know what to do. Run your rooms, work the patient in front of you.” He looked to a nurse. “Nurse Khev, you’re with me.” He grabbed an emergency medical kit and swept out, Nurse Lena Khev not far behind.

Engineering teams flowed into the area. Panels were removed, power was cut to sparking and dangerous wiring. Debris was moved out of the way. Back up generators hooked up to ensure the forcefields held. And all the while they helped look for injured cremated.

Huzzen, eng

Drake ran into the area. “Injured go through me. Non-critical up to sick bay or surgical. Critical cases stabilize here and turf up.” He forced the emergency kit into Nurse Khev’s arms. “Let’s move.”

-Lt Cmdr Drake Marshall, M.D.

Just as critical patients on Deck 8A and all hit biobeds, the comms lit up, =/\= NE Th’zhaaniq to Marshall =/\= an accented voice rang out, =/\= We are sending 5 black tags to the morgue. Eight yellow tags being stabilized and ready for transport on your command.=/\=

GM Wombat

OOC: Edited Geoff’s post as discussed with him. We’ve had to retcon the location to Deck 9A (not B) to be consistent with the damage on the other decks. A note on this deck too is that it’s likely based on the spec that the area hit here is a cargo bay. Do with that what you will.

In the cargo Bay, the breach was now apparent with the forcefield solidly in place. Debris was strewn everywhere, and cargo containers had rolled and fallen. At first there was no obvious sign of people, but an arm was visible out from behind one large container on its side. Another person was visible lying on the catwalk alounge the upper perimeter of the cargo bay and the metal bars had stopped them from being pulled across the bay towards the hole the hull.

~Mischief Maker

Marshall had the triage well in hand. Alexis moved into the cargo bay behind the security and ops officers that were securing the path in. She pointed to the arm under the container and they moved that way. Alexis knelt down scanning with her tricorder while the others worked to move the container off the individual.

Lt. Cmdr. Kane, AMO

There was still a pulse, but faint and there were signs of internal trauma as well as multiple serious fractures. The container was removed with some difficulty, revealing a young Andorian ensign in operations gold.

Alexis read the scans and spoke, “I need a volunteer.” One of the security officers stepped up, “What do you need doc?”

“He’s not stable enough to transport. I’m going to establish a neural link so your body can stabilize his. Dr. Walker will remove it once you arrive in sickbay.” The officer nodded, “No problem.” Alexis placed the small devices in the officer’s forehead and that of Andorian officer and then engaged a link. “Just breathe normally.”

=/\=GALEN Emergency medical transport to primary sickbay.=/\= “Yes Doctor.” And the pair disappeared.

=/\=Kane to Walker. Emergency transport in progress. Patient is early 20s, Andorian, multiple fractures, internal trauma, pulse present but threads. Neural link has been established.=/\=

=/\=We’ve got him,=/\= Brad replied after a moment.

Drake moved into triage. “Khev. Open.” Drake walked over to the lineup of yellow tags and started scanning each one, checking to make sure they were stable enough to move. He had brought Nurse Khev along for a reason. They worked fluidly together, he always wanted her at his right hand in a situation like this.

-Dr Drake Marshall

Lena had the medkit set up as quickly as possible. All the tools of the trade were ready, and she monitored every patient as closely as Dr Marshall, to anticipate what needed to be done next and what he would do next.

-Nurse Khev

=/\=Attention Decks 7, 8 and 9. Please be advised that non-essential power will be cut immediately to prevent further power surges. Take all precautions. That is for all of Decks 7, 8 and 9,=/\= GALEN’s voice said over the entire deck.

One of the med techs called from up on the catwalk. “Have another up here. Needs a doctor quick. Vitals are weak. Visible head trauma.”

~Mischief Maker

Drake’s eyes shot up. Damn it. He ran over to the ladder and climbed up. He moved down the catwalk and toward his patient, kneeling down when he was close. He opened his medical tricorder and spoke to the tech. “Observations. Give me the highlights.” Anything not immediately visible on scans that the tech had noted might prove useful.

-Dr Drake Marshall

“Their position suggests that the vacuum created by the breach pulled them against the catwalk. Could mean lung issues even if there’s no obvious damage. Laceration to the top of the head suggests that was where they hit first, but the cut is superficial,” he said, pressing a compress to staunch the bleeding. “I’d worry about traumatic brain injury as well, though I haven’t been able to check pupils yet.”

The tricorder picked up the rest of the details: namely that there was a slight elevation in intercranial pressure and mild compression on the phrenic nerve (that signalled the diaphragm to relax and contract) and this was likely causing the irregular breathing and lower oxygen rates Marshall was seeing.

~Mischief Maker

Drake pulled out a small flashlight and pulled the patient’s eyes open, flashing it across their eyes to check their pupils. “This might be a busy one. Lucky to be alive. Head trauma definite, checking TBI, impact compressed somewhere south of C3. Hit their head so hard they can’t breathe.”

-Dr Drake Marshall

One of the man’s pupils were dilated, indicating the seriousness of the head injury.

Alexis stood and followed the officers clearing the bay to the next casualty.

Lt. Cmdr. Kane, AMO

There wasn’t anyone else obvious in the cargo bay.

~Mischief Maker

Alexis looked at the officer in charge of the sweep, “Call out if you find anyone else.” Then she turned and climbed the ladder up to where Marshall was. “Dr. Marshall, do you need any assistance?” Marshall was a capable doctor and excellent surgeon, but she wasn’t going to vacate the area without checking with him before she did.

Lt. Cmdr. Kane, AMO

Emergency repair teams swarmed the area around the breach and got to work diagnosing the major problems and securing bulk heads and removing debris.

Lt. Huzzen, Engineer

Drake called down to Alexis “Your call. I can handle it, but an assist might speed it up. Head injury, definite TBI, intracranial pressure says subdural hematoma, compression on the spine is pinching the phrenic nerve so breathing is shallow and uneven.” He moved his tricorder over to confirm that the pressure was due to blood and check for fracture in the skull. He glanced up to the tech. “If I’m right and we have a bleed here, we need to evacuate the blood. so I need you to be ready. May not be safe for transport with their brain like this.”

-Dr Drake Marshall

Cmdr. Dr. Brad Walker
Chief of Staff

Alexis climbed the ladder and moved over to kneel on the other side of the injured officer. She looked at her own scans, “Not the cleanest place to do this, but we can’t move him like he is. I will assist.”

Lt. Cmdr. Kane, AMO

Drake nodded. “Okay. I need to put an exact size on the bleed, if theres a fracture, we’ll use it. Lift the skull away and drain. Once that’s resolved we need to move south, to the cervical spine. I’m going to need you on drainage with the bleed, and guidance with the nerve.” He looked to the tech. “And your job is to have manual ventilation on standby. They’re not dying on my watch.”

-Dr Drake Marshall

“Yes, Doctor,” the tech said, grabbing wha they would need from the kit.

Alexis flipped open her kit and locked the lid in an uptight position she attached the probe of her tricorder to an adjustable arm and then the man’s scans and images showed up on a built in screen of her kit’s lid. It was a new set up from their R&D department. A benefit of being one of the Drs. Kane. She pulled out what she needed to drain the bleed to relieve the pressure and surgical equipment to hand ti Drake as he asked fir it. She grabbed a small handheld asceptic scanner and cleaned her hands. She offered it to Drake. “Ready.”

Lt. Cmdr. Kane, AMO

The med tech also cleaned his hands. “Ready.”

Scans showed there was indeed a 1.2 cm subdural hematoma that was slowly growing centred over the frontal lobe and currently measured. Despite the head laceration, there was no skull fracture. ICP was climbing slowly.

~Mischief Maker

Drake put on a pair of glasses, sterilized his hands, and drew a scalpel out. He took a deep breath. He lowered his hand and started cutting a small area above the bleed. 1.2 centimeter lines formed a square of skull. “Doctor Kane, you’re up.” He pulled the segment of skull away and left an opening. “Once all the hematoma is clear, I need you to visualize the pinch on the phrenic nerve. By the time the skull is closed, I want to be able to work the spine.” Drake was a notorious loner and the things he asked of surgeons working with him made the reason for that very clear.

-Dr Drake Marshall

Marshall’s manner didn’t phase the AMO. No one liked working with her either. She knew what to do and did it, and demanded those around her follow her instructions exactly and swiftly. She gave the exact same when she assisted. She had the suction and irrigation ready and went to work on clearing the fluid and blood causing the swelling and pressure. She worked quickly so Marshall could continue, “There,” she said a minute after she began. She passed the suction and irrigation to the medic assisting and began looking for the best visual of the phrenic nerve.

Lt. Cmdr. Kane, AMO

The med tech took the proffered items and helped Kane find a clear path. The left nerve was visible and it was clear the surrounding tissues were swollen. There seemed to be some bruising that was causing the compression.

Meanwhile, the intercranial pressure was slowly coming down as Marshall worked to clear the hematoma.

“Heart rate is increasing, pulse-ox dropping,” the medic called out.

~Mischief Maker

“Keep them alive.” Was Drake’s answer to that. “Doctor Kane I’m going to need some good news soon.” He said as he started to close the site on the skull. He was hoping it was a compressed disc or the like for the relative ease of fixing. But Drake had learned better than to expect favors from the universe in situations like this.

-CO

The medic didn’t reply to Drake other than a nod. The curt response sitting on his tongue was ‘No shit’, but it felt unnecessary at the moment.

“I have a visual on the nerve. The surrounding tissue is swollen from severe bruising and is causing the compression.” Alexis glanced at the other tricorder, “Intracranial pressure is reducing, slowly but steadily.”

Lt. Cmdr. Kane, AMO

“I’m not sure his blood pressure could handle an anti-inflammatory,” the medic said. “Though if it’s enough to reduce the swelling enough, could we transport him and then deal with the sudden pressure drop in Sickbay?”

~Mischief Maker

“Quiet.” Drake moved his scalpel over the inflammation and then he pulled back. He loaded a spray applicator with a topical corticosteroid. “We’re going to do this here. I’m going to open the site and do it locally to try to keep BP up. Get ready to call in a transport.” He made the incision and began spraying the steroid when the inflammation was visible, trying to reduce it as much us possible.

-Dr Drake Marshall

Alexis tapped her combadge ordering secondary sickbay to have a surgical suite prepped and ready for Dr Marshall and a crash cart prepped as well. In the event they couldn’t transport she called down to the response teams to have a gurney ready to move him. She kept the tricorder concentrated on the incision location and prepped the emergency pulmonary and neurological stabilizers. She also set up an infusion unit on the officer’s arm. She only had saline fluids with her, but it should help counteract any blood loss from the procedures, for the moment.

Lt. Cmdr. Kane, AMO

It was an agonizing wait to see if the application of the corticosteroid worked, but after a couple minutes (and the tech continuing to read out vitals), the inflammation reduced by 3mm. It wasn’t a lot, but it was just enough for things to start to shift. “Oxygen saturation has risen 2%.”

~Mischief Maker

Drake closed the site and said. “They should be stable enough to ship. If the corticosteroid isn’t enough, we can work systemically from sickbay and not worry about a code so much. Send ‘em out, yellow tag. We probably have more work to do and more critical care in both sickbays.”

-Dr Drake Marshall

Alexis called down to a pair and a team scrambled up to the cat walk and prepped the patient to be transported. She looked at Drake. She nodded once, he did a good job, and he knew that he did. She saw no point in stating the obvious. “There are no more obvious injured. It will take time to clear the whole bay and the other decks. Check in with Walker. If he needs you, go, I’ll stay here.” Alexis turned for the ladder, paused, and looked back. Perhaps stating the obvious wasn’t necessary to her, but she had been told she needed to learn how to acknowledge good work as well as mistakes. “Good work, Doctor.”

Drake nodded and smiled slyly. “You too, Doctor Kane.”

She slid down the ladder and tapped her badge, asking for updates from the other response teams.

Lt. Cmdr. Kane, AMO

OOC: Not sure which medical bay the patient went to (though Secondary is closer), but we can continue with him there if you like, or move on. I’m fine either way.
IC:
There were reports from Deck 8A that indicated medical had been called to a stuck turbolift, plus there were several injured on that deck that were either still being removed from debris or were being assessed and moved for medical care.

The same went for areas outside the cargo bay where they were now on Deck 9A, though given its proximity to the connection to the secondary hull (and the emergency bulkheads had been activated), the area of the breach on this deck had been a priority, so most people had already been recovered from this deck.

~Mischief Maker

=/\=Marshall to Walker, you’re receiving a patient with inflammation pinching the phrenic nerve. Managed locally with corticosteroids, but still needs work. Shouldn’t be too hard with what I left you. Where do you need me?=/\=

-Dr Drake Marshall