I'm alive! Well sort of, been so busy with work and schooling all my brain can come up with is work related stuff soooooo I guess it makes updating this fic possible =P. Sorry for the long wait, I don't know if I'm starting to get a bit too technical and all with this story but ah well, its a good place for me to empty my mind
I'll try to update the other stuff as well, been working on it but I want to get a bit more written before I post them... and.... I will be disappearing for a month of vacay. Not sure if I will get any writing done or if i will have internet so we will see.
**~ Special Thanks to HashirePomeranian for helping me beta this, and still waiting for your update to Contamination and God of Rock and TJBC!
~**Now the replies:
Pommie: I guess there isn't enough atsumina to bring in the comments and my writing scared people off haha. I think I'll have more about Yuko he next next update =p, as for Sasshi moments.... still thinking about them.
sakura_drop_: just calling me immoK is good, i'm getting to lazy myself to type out the full immortal too =p. hmmm maybe I should add more Rena moments, but I can tell you for sure she will have her light in the story later later.
Megumi: LOL funny is that is what we do to the rookie's here, pretend to be all serious and tell them how things are done then laugh it off together.
Pandah: Thanks, glad you don't mind all the technical an medical stuff that is going on. To myself when I write this it seems easy to understand but then I know for others it can get very confusing. Don't worry I won't just leave Yuko alone, she will have Takamina and Acchan to help her and who knows what will happen later.
Miaaaaaaa: Wahhh you did bump this hmmm a long while ago HAHAHAHA. So because you wanted to me update this one, guess what =) I will updatethis first.
Crossing Crossroads: Thanks for the comment, I didn't think this would be bumped and reappear on the first few pages. I just have to put Aamin in a character that will appear more then just cameo in the story cuz she is awesome Mayuge-bon~. LOL don't be so fast to decide on the pairings because life is unpreditable right?
Still waiting for the last Matsui to make her entrance but for sure Jurina will be around to cause trouble for the doctors and nurses hahahahaha. Can't help it she is only a kid =). I don't know about the others but I really refer Shimada over Shimazaki. Once I can think up more Sasshi's "rare case story telling moments I'll add them"
Living in Emergency: PAGE 7 ~ Practice doesn’t make perfect, it brings permanence. Human’s are not made to be perfect ~"Ahhh, so bored!" Sae complained lying on the couch in the respiratory department, holding the same magazine she picked up a few hours ago.
"Don't complain, it's nice to get some break time once in awhile." Miichan said from the desk while snacking on her sandwich.
"But we haven't had any calls since this morning." The energetic girl whined, missing the action and excitement their normally busy shifts bring.
"Say, I heard you know that new good looking young resident in emergency, heard you two went out for dinner together." Sasshi asked, looking up quickly from the computer to join in the conversation before turning back to the concert playing on youtube.
"WHAT! Where did you hear that from?"
"You’re overreacting, it's obviously true." Myao commented after just entering the room.
"You didn't even hear the question...."
~~~~~~~~
*In Emergency*"Mayuyu, you okay? You've been sneezing quite a bit today. Hope you aren't coming down with something." Dr. Aamin asked while still going over her patient's chart.
"I'm fine, I think someone is talking about me." Dr. Watanabe frowned.
"If you say so, but just keep clear of Dr. Matsui until her melon pan arrives, she's been in a bad mood since my sister and midgi-Mina decided they can't come in and need a cover." the young Maeda explained.
"Ah is that why she has this black aura surrounding her all morning?" Mayu asked, remembering how most of the staff has been trying to minimize contact with the dangerous doctor.
"I already called her sister and told her to bring in some melon pan. Those usually work and I really hope they would."
"Aamin! Are those charts done?!" The deadly voice transmitted throughout the department, bringing shivers down the spine for those who are waiting to speak with the owner.
"Right here, Dr. Matsui." With the speed of light, Aamin appeared beside the easily irritated doctor, showing her the charts for a sudden chart review of Aamin’s performance.
"Thanks." Rena said, realizing how snappy she is being while rubbing her temples to relieve the phantom ache she's been feeling all day.
*Some hour later*
"Good afternoon Hata-san.”
“Ah Jurina, here to visit your sister again?” The unit clerk, Sawako, asked pausing from deciphering the scribbles on the orders sheets.
“Aamin asked me to deliver some melon pan. Have you seen my sister?” Jurina asked. Since her last visit as a patient, Jurina developed a liking to the hospital and interest in this field of work. She would come often to visit her sisters and get to know the staff when Rena is busy.
“Hmmm I’m not sure. Akicha, have you seen Dr. Matsui?” Sawako asked the approaching nurse.
“I think she’s in the office." She replied, finally looking up from the chart she was reading. Out of reflex or safety response Akicha started to inch away from the young visitor. A flash of that incident once again appeared in her mind.
Sawako saw Aki's reaction and couldn't help but want to laugh, but being a professional unit clerk, she held it in and pretended to pick up something from under the desk. A few shaking and trembling moments later, Sawako straightened herself in the chair. Sawako found Jurina still standing there by the counter, spaced out looking across the room.
"Jurina? Dr. Matsui is in the office." She spoke up, trying to snap the girl back to reality.
"Hata-san, who's that girl?" Jurina suddenly asked.
"Which girl?" Curious as to who the girl is referring to, Sawako spun around in her chair in the direction Jurina is looking at.
"Oh that's...." She didn't bother to finish since the younger girl had already disappeared in a beeline towards the two young resident.
"Mayuge-bon!" Jurina shouted excitedly, hugging the taller girl. "Ah why are you so tall?" She pouted, having to look up to ask her question.
"Thank god, Juju we have been waiting for you to come save us!" Dr. Aamin returned the hug happily.
"Aamin, Aamin ,who was that with you just awhile ago?" Jurina asked looking side to side and behind the tall girl she is still hugging onto.
"With me? You mean Mayu? She is the new resident Watanabe Mayu." A confused Aamin asked, trying to stable herself from all the sudden movements caused by the koala still attached to her.
"Hmmm Mayu, where did she go?"
"To the lounge to get some water, why? .........Juju? Juri? Jurina!" Aamin almost lost balance again when the koala suddenly ran off heading straight towards the lounge. In her mind, she thought of the best way to get even for being mostly ignored so Dr. Aamin made her way to the doctor's office to notify their lovely Dr. Matsui that there is melon pan calling for her in the lounge.
*In the lounge*
Dr. Watanabe stood there leaning on the back of the couch satisfying her thirst with a cup of water. The day has been busy and much more intense as Dr. Matsui made sure she stay on her toes, pointing out her flaws and things that could be improved. Of course she is grateful for all the constructive feedback but when they all come together like a landslide it is a little hard to adjust.
*Bang*
Her thoughts were interrupted by the sound of door opening and in poked a head looking around.
"Hello are you looking for someone?" Mayu asked not sure if she met or seen the girl before, she appears to be younger but Mayu can't be certain.
"Hi, I'm Matsui Jurina." Seeing the extended hand Mayu reacted like anyone would as a way for greeting.
"Watanabe Mayu, a new resident. You must be Dr. Matsui's ..." The young doctor wasn’t able to complete her sentence when she felt a tug on her arm causing her to lose balance.
“Chu ~ kekeke”
"MATUSI JURINA!" A roaring voice came from the doorway.
"Oops." Jurina quickly let go of the hand she is still holding, before had a chance to turn around, she felt intense pain tug on her ear and was then dragged out of the lounge.
"Ahhhh, Rena-chan ow, ow, ahhh."
"You are coming with me to Saki-nee." Rena said still dragging her younger sister by the ear, of course she made sure her melon pan is safely secured in her own hands first.
"Nooooooo, Rena not nee-chan, Aamin! Aamin! Save me!" The struggling Jurina begged as they passed by the emergency room where everyone watched the commotion.
"Hmmm Mayu you okay? Did something happen?" Dr. Aamin asked when she found the girl standing still as a log in the lounge with one hand over her lips.
“......”
“Dr. Aamin and Dr. Watanabe stat to resuscitation bay! Dr. Aamin and Dr. Watanabe stat to resuscitation bay!” Hata Sawako’s voice came through clearly on the overhead kicking the two doctors back to reality.
“Abe, what’s the case?” Dr. Aamin asked as she watched the paramedics roll their patient in on a stretcher.
“Suicidal attempt, cutting and lost a lot of blood. The cheating girlfriend found her on the floor holding a knife and already bleeding out. The girlfriend reported the patient was still conscious when she found her but went unresponsive by the time we arrived.” The first paramedic, Abe Maria, reported while her partner help the nurse transfer the patient over to the hospital bed.
“Do we have a name? Any other medical history?” Dr Watanabe asked while she moved to assess the patient.
Maria took a look at their charting and answered, “Kashiwagi Yuki, female, previously healthy.”
“Thank you." the doctors replied before giving out some orders.
“Dr Aamin, we were able to insert two large IV’s on route, we started running some normal saline as well." The second paramedic replied after making sure the patient is secured with the nurses.
“Akicha, run another two liter of normal saline bolus from the IV’s wide open, insert another IV site if possible.” Dr. Aamin instructed.
“Yui can we get two units of packed red blood cells, and fresh frozen plasma, cross matched. She lost a lot of blood and will most likely need transfusion if hemoglobin comes back below 80." Dr. Watanabe added as Aamin moved to the bedside to do the initial assessment.
“Blood pressure is borderline, if the mean pressure drops below 50 then start some inotropes, if not let’s wait and see if we can fluid resuscitate her." Both doctors looked as each other and with quick doctor to doctor eye communication they nod in agreement to the plan they have set. With the immediate care plan set the emergency nurses moved around each other quickly getting everything set up and running.
“Hata-san, can you call Kuumin to resuscitation bay and do a set of blood on this patient, full lab work please." Dr. Aamin said to the unit clerk.
“Can we get a urine toxicology and screen as well?” Dr. Watanabe asked her senior as the idea came to mind.
“That is a good idea Mayu, Hata-san can you enter the order for urine toxic as well, there could be a possibility the girl took some drugs as well."
“Just make sure to monitor her fluid balance incase we overload her with fluid causing it to flood into the lungs and lead to respiratory failure." A happy Dr. Matsui came from behind the two young doctor’s causing them to jump from the sudden appearance.
“Good work both of you." Dr. Matsui finally gave them a compliment before leaving with her precious melon pans and a satisfied grin from being able to scare the little ones.
~~~~~~
*BEEEP* *BEEEP* The distinct alarm blared overhead causing all the lazing RT's to suddenly jump to their feets.
"CODE OB, LABOUR AND DELIVERY! CODE OB LABOUR AND DELIVERY!!"
"SAE! This is all your fault!" Minegishi, Sashihara and Miyazaki shouted as they quickly dropped what they were doing and ran out the door with Miyazawa Sae following behind.
"What's code OB?" She asked easily catching up to her running seniors.
"Obstetrics, pregnant mother in labour with high risk, all RT runs to them and decide how many need to stay after we arrive."
"Oh."
As they near the delivery room they can already hear the loud screaming and shouting that is typical of a mom in labour expect this time there is still 2 doors between them and the room. The volume of the screams of pain from the contractions escalated as each door opens for them to pass through. Sometimes they wonder why people would want to go through all this pain. It sounds 10 times worse than those being tortured or those horror movies.
"Haruu, Moeno? Did you bring her in?" Minegishi Minami shouted over to the two paramedics standing at the end of the hall right outside the room they are heading towards. Sasshi and Myao stopped outside the room to prevent crowding inside but staying within earshot so if needed they can be summoned. The other two ran into the room and straight to the warmer to make sure they have everything they need. Once they made sure the warmer is on, their respiratory equipment and suctioning devices are all set, they took a look around and ask the most important question.
"What happen? Baby full term?" The simple terms were shouted out towards the nursing staff making sure it can be heard over the screaming and thrashing mom.
"She just arrived by ambulance, full term, we found the baby with serious heart rate decelerations, worsening when she tries to push with contractions. Suspect the umbilical cord is wrapped around the neck, that's why... Haachan is holding the baby in place." One of the pediatric nurse replied.
After the nurse reported their findings both RT looked over to the mom in distress and sure enough at the end of the stretcher is a brave nurse, Katayama Haruka, standing there with her hand up....... holding the baby in place preventing it from being strangled to death. Sae turned back over to Miichan with eyes wide open trying to confirm what she just saw.
"Errm, what is your name?" Miichan asked the nurse that gave them the brief in attempt to change the focus as they wait for further instructions.
"Kasai Tomomi, one of the neonatal and pediatric nurses. Dr. Itano is on her way and will be here in a couple min, we are going to transfer into the operation room (OR) shortly when the room is ready for emergency caesarian section. chiyuu~"
"Sasshi! We are moving to OR, check the equipments there. We will stay with the mom." Miichan shouted over everyone towards the door then waited until Sasshi poked her head in and gave the okay sign. Of course there was also a second of surprise as she took in the scene.
"You did that on purpose." Sae said as a fact after seeing a smile grew on Miichan's face.
It didn't take long for them to move over to OR with the nurse hanging onto the stretcher, hand still holding the baby in place to prevent the cord from strangling this precious life. Miichan moved ahead to get in position beside the warmer waiting for the baby to be born.
*Dr Itano Tomomi’s POV*"I'm Dr. Itano Tomomi and I will be in charge." I quickly introduced myself short and simple, before giving some instructions.
“Miichan you will be in charge of compressions and equipment, Tomomi I want you to tap me the heart rate and if need insert an umbilical line. Haachan you will be in charge of medication if needed."
I had to pause to read the name off the name tag before I could continue, “Sae you will be in charge of airway and breathing." All of this is to prevent any confusion later on when the baby arrives.
I check the clock waiting as I watch the time tick away slowly with the rest of the team. I can feel the tension begin to build up from the anticipation as each second that pass there is an increase chance that this baby won’t make it. The sound from the doppler clearly resonate each beat of heart rate it measures. Seventy, only seventy beats. I took a deep breath as this is the last stretch before the baby comes out. I can see the surgeon reaching in so any time now.
"Baby is out start the timer" That is my signal and as if someone press the start button, I took the newborn over to the warmer and within seconds I assessed the most important factors.
"No breathing, no muscle tone." I clearly called out what I see to the team as they dried her with some towels. I watched Tomomi flicks the sole a couple times hoping to stimulate some breathing efforts but no luck this time.
"Sae start breathing ventilation." I looked over to Tomomi who’s been working as me for a long time, without words she understand what I am asking her and started to tapping the heart rate for me to see.
"70 beats, heart rate is not rising, Miichan breathing tubes." I quickly got into position and took the tubes from Miichan then skillfully place the tube through the vocal cords and into the lungs. Thank god I practice my skills day and night back in the days, I always believed that practice only makes permanence and not perfect. No one is ever perfect you can only practice to make sure you don’t screw up as much. That’s why I believe in practice only makes permanence.
"Chiyuu~ Heart rate is below 60 now." Tomomi spoke up pausing her heart rate tapping alerting me that we should move onto the next step.
"Miichan two finger compressions, Tomomi I want that umbilical venous line, Haachan can you draw up some epinephrine for UV line. Remember 0.1-0.3mg only." It's already been 2 minutess since the baby is born and as each min pass there will be an increase chance of death or serious neurological problems, we are running low on time. If we lose the heart rate we will lose this baby within 10 minutes of that.
"Okay focus, coordinate the breathing and compressions, just like that. Good." From time to time I make sure to reconfirm what we are doing.
“Dr. Itano, this is 0.3mg of epinephrine." Katayama Haruka said as she passed me a labelled syringe.
“Doctor the UV line is ready for use."
Once Tomomi confirmed the UV line is in, I administered the medication quickly then watched the full resuscitation continue for at least another 45 seconds before prompting for another heart rate check.
“Tomomi what is the rate at now?” I asked in my mind I pray for this kid.
“75 beats doctor." She replied with a hint of bubbling joy.
“Good we are heading in the right direction, Miichan you can stop compressions. Sae keep breathing ventilation until the heart rate is higher than 100 beats per a minute (bpm).”
Within the next minute we watched the girl slowly make breathing efforts, weak but an effort is an effort. Her heart rate climbs steadily till it is over 100 bpm, but unfortunately her breathing isn’t able to maintain on her own without help. Otherwise her color, oxygen levels, heart rate and tone has now reach acceptable and sustainable levels.
After a couple more minutes when I am satisfied with the baby’s current state I decided it is time to take her to neonatal ICU (NICU) so we can closely monitor her in case anything else she needs more support.
“Heart rate is 124 bpm, breathing is borderline but showing improvements, oxygen levels look good, she is stable enough now, let’s take her to NICU so we can continue to monitor her, she might need some more breathing assistance so can one RT accompany us for the transfer.” I announced to the team.
Working with babies have always been very intense and satisfying when our efforts paid to allow innocent little life a chance to see the world. To me they have done nothing wrong, so to be finally able to take their first breath, see the first image and shout out to the world of their arrival is a blessing. The sound of their crying in a way is also the most beautiful sound one can wish for in a delivery room, the strength behind each cry is like a statement to the world they are ready to take you on. Sometimes I wonder why a baby covered in blood, in slime, in white sticky secretions can be the most beautiful thing in the world, but when I look at them there is just no words to describe how cute they are just like an angel.
“Congratulations you gave birth to a baby girl.”
Topic: Living in Emergency (LiER) ~Dec 24~ (Read 44153 times)