St. Gardena - Emergency Department

[Chris07 10]

St. Gardena Memorial Hospital - Emergency Department

[losangelesi 5]

The Hospital: Sub-Acute ER, Primary stroke receiving, Level 4 trauma, and labor & delivery.

 

The hospital is under M.D Cardiologist Neurologist Bae.

Edited January 16, 2020 by losangelesi

[Steve Bae]

I come into my ER, covered in sand and go to my desk. Ah. Work. Good thing I have google, I think about surfing and riding by motorcycle, and remember that I need to sell it to pay for my 4th divorce.. good thing I don't owe alimony. ah.. the smell of sick people.

[C. Johnson]

'I hear some nurses talking about a crash down the road. I'm new here but I think to myself, this blows. The chance of us getting one of those patients is decent. Good thing I have all of this training. I should have independent practice rights.'

I walk down the hall and see doctor Bae. He looks like he could be on Greys Anatomy. He also seems strangely terrible at his job, especially for all of his qualifications. Damn. He walks by and says hi. I say "hi" back. Either way. Hes gorgeous, and that's why we forgive him. I think that's why patients tend to forgive him too? 

[L. Sparks]

11:30pm - Friday night

Medic 1 backs into the ER bay. The bay is empty, and the ER...actually looks pretty dead for a Friday night. I'm surprised.

The back of the medic smells like a God damn brewery....if the brewery was staffed by 500 sweaty men in the dead of summer in Alabama. To continue with this analogy, those 500 men don't believe in deodorant, and they haven't bathed in about 3 months. Unfortunately, I've inadvertently just described our patient. No amount of deodorizer will ever get this smell out of the back of this ambulance. We're probably going to have to burn it.

The seconds it takes Breslin to get from the front cab to opening the back doors seems like hours. I think my eyes are starting to water from the stench.

We picked this dude up under a bridge, as is typical for a 'man down' call. When we found him, he had 2 of the corner liquor store's finest quality plastic pint bottle vodkas...you know...the kind that's probably 50% vodka 50% kerosene.

Unfortunately, our beloved boys in law enforcement arrived before us and gave the inebriated man the ultimate decision: Go to jail or go to the hospital? What could this man answer? Was jail really even a real option?

So here we are...luckily the ER looks dead.

As soon as the back doors open I jump out...taking a deep breath of fresh air.

'Holy jesus!' I say to Breslin.

'I'm going to have to burn my clothes.'

Our patient is sleeping..probably dreaming of the turkey sandwich in store for him soon.

 

 

[A. Breslin]

*I walk around the back of the truck as Logan is halfway on the back step.*

'Jesus Christ. You would think this asshole would have some sort of self awareness. If I can smell you from 3 fucking blocks away there is no fucking way you can be noseblind to that. If that bitch redhead cop ever gives him the option of going with us or going to jail I will lose my job. Whether or not its a homicide or an assault depends on how fast you can stop me.'

After being a paramedic for 9 years and being subjected to all kinds of horrible smells this was the worst. Worse then finding the putrefied body in the unventilated unairconditioned apartment. Worse then the Lady whose favorite food was pickled herring had the GI bleed.

'This guy smells like hes rotting.' *I say as Logan unlatches the stretcher and drops the legs. I unlatch the back. Looking into the back I think I saw something move.*

'Logan, I think I just saw something move. I am not joking.'

*I close the doors and push the stretcher towards the ER doors.*

'When we get back to the station were parking this in the back lot and leaving all the doors open and were letting it air out. The smell will scare off anything aside from sewage plant enthusiasts. Do you know whose working Gardena tonight?'

*The automatic doors open for us. I can see the clerk at the desk looking in shock and horror. One of the volunteers starts gaging.*

[L. Sparks]

'I have no clue. Who's working tonight.'  I say as I look for something moving on this guy.

'I'd say I'd look for something moving but I wouldn't touch that with a ten foot pole.' I say to her with a dead serious tone.

I close the back doors and we proceed inside.

As soon as we enter, the entire nursing staff looks at us. I'm positive they can smell him already.

He continues to snore.

The nurse sitting at the desk nearest us looks up.

'Is this the drunk?' she asks.

'The one and only.' I reply.

'God, where did you pull this one out of?' she says disgusted.

'Just wait here.' she says as she walks off.

I post up against the wall out of the way but in clear view of everyone. 

'So are we using bleach, acid, or fire to clean the truck? Or perhaps all three?' I ask Breslin as we apparently wait for no reason since several beds are visibly empty.

 

[Steve Bae]

I come out of the attending room and see EMS in the hall and the nurses are hardly paying attention. I come down the hall and smell the smell. Theres nobody in the ER, 0 patients until now. I yell out. "HEY, IS THAT AN URBAN OUTDOORSMAN? I DONT CARE. NURSES, PUT HIM IN A WHEELCHAIR AND GIVE HIM A SHOWER. HE SMELLS LIKE SHIT. IF HES x3 GIVE HIM A SANDWICH AND KICK HIM OUT."

[C. Johnson]

My first patient with doctor Bae smells worse than anything I've ever smelt. I hear Doctor Bae and ask my alert and oriented questions and take a turnover from the ambulance drivers, quite a bit nicer even though I feel like I'm going to vomit. 

 

Then I see it. An air freshener tree on a registration desk. I shove them in the dudes clothes. "Did you guys have anything else before we turf him?" I say with a trying smile, I'm very nautious at this point. 

[Steve Bae]

I come back out after he's showered. It still smells bad but not as bad. "alright, kick him out."

[J. Weston]

We arrive at St. Gardena and come in. 

I see doctor Bae and I know hes going to ask why I didnt treat. I know hes going to laugh at me. But I dont want my partner to hear it because he might actually feel better about his job. 

 

I see Doctor Bae coming toward us, he seems to be in a good mood. He asks what's up, I give him my report. 

He asks why I didnt give at least tylenol IV, I explain that I took 4x the amount of pre workout. He warns me and also laughs. 

[Steve Bae]

What an idiot I think to myself. We bring the patient back with abdominal pain, I google what I should do to make sure, and they get sent off for labs and tests while I go back to my office and play with gundams like any good doctor would. Wheres the surf when I need it. 

[Steve Bae]

*a patient comes into the ER smelling awful. I look at them. its the same damn homeless person from earlier. I walk out*

 

"what do you want?"

Urban outdoorsman "another shower and a sandwich?"

I say "sure, but you have to play a game"

*the bum gets angry and charges me*

The security guard tackles and tazes the bum, beats them with their baton and pd shows up and tazes him again. we take him in the back, I close the curtain and give 5 of versed and  the nurses restrain the patient. I have a nurse start an IO. RT gives Succs and Etomidate and I RSI the patient. A cop tazes him again for good measure and we all laugh. And we don't report it. It turns out he got a lot of injuries including a skull fracture. I think about a trauma transfer as the right thing, but hes a bum. I walk out and do the same thing i saw in a documentary. "Sorry, he's brain dead" I know he's not. He has no family. the nurse shrugs. we give a bit more etomidate, turn off the vent and monitor and walk out.

 

Stupid bum.

 

The bum takes his tube out and walks out without me knowing.

It's fine. I call my assassin and he takes him out. Cost me a Mill but it wasn't a malpractice suit. Time to fly to Tai Pei, I put on my sick glasses with the sunset behind me walking toward my helicopter. My filmographer gets it on camera, it looks pretty sick so we use it to help get my pilot episode considered for my own show about being a rich ER physician, while I actually am. Hell yes.

[Steve Bae]

I look out the front of my glorious ER. I think to myself. Today is going to be a great day. Not even 2 seconds after that thought a transient tries to open the ambulance door. Security pulls him back and fights him, he's a combative dude. 

He finally gives up and says he wants to go to the hopspital. I get the biggest smile on my face "YES! COME IN FELLOW HUMAN, HOW CAN WE HELP YOU?" as security is holding him. He says he wants help cause he has the pains. 

"OH, YESSS SIRR. LET ME HELP YOU WITH THAT."

 

They put him on the bed, i have the security restrain him. He says what the f, he has rights. 

 

I laugh, ask him ao questions and he gets antsy, so I rsi him and get him set to the back corner of our ICU. I whisper to him "thats your pain medication ✌" 

 

Then I think to myself. Should I transfer him out?

Decide yes. 

 

Call the ALS IFT. "Hey, uhhh. I need this guy transferred out to uhhh... Shiloh County Medical Center. He's tubed and uhhh. Yeah."

I kneel down and karate punch the air after my successful work. Just like a doctor on my favorite TV show. 

[L. Sparks]

'Shit. We lost it again.' I say as I feel the accident victim's neck for a pulse.

'Jump on it.' I say to my partner who starts compressing.

This patient is a mess. Both legs missing, arm is like jelly, head and chest all cut up. If he survive's it'll be a miracle.
The fact that he's made it this long is no less a miracle. The car he was extricated from looked like a pile of scrap metal, and in no way resembled the Subaru GC8 we pulled him from....I guess that's what happens when you hit a wall at 95mph.

The monitor shows a tachycardia, but there's no pulse. We've lost and gained a pulse 4 times since we started transporting this guy. Normally a guy like this would go to an actual trauma center, but due to his grave condition, protocol states we have to take him to the closest receiving facility....so here we are....pulling into St. Gardena. 

The firefighter recruited to drive my partner and I into the hospital backs into the bay.

*I do one last pulse check before we unload this patient.*

*I feel a pulse again*

'....and he's back.' I say.

We unload. Our rig is an utter mess, we're going to be out of service for a bit cleaning this up.

*We burst into the ER*

"Here's that trauma" I say out loud hoping for someone to direct me to the right direction.

[Steve Bae]

"OH HEY BROS, WHATS UP! COME ON INTO THIS ROOM RIGHT OVERRRRRRRRrrrrr........"

They wheel closer and i see this horrendous mess of a person. 

"Are you sure its alive? You sure?"

I forgot that I am a level 4 trauma physician. I tell my nurses to get vitals. I 100% ignore EMS's report and scribble on their signature box. The nurses are doing what they can. 

So I go back to my desk, pop some confidence pills, go back in the room, see that he has a pulse. "Let's get x-rays, a chest tube kit, central line kit, get all the o neg you can, TXA, and an ALS transfer to Shiloh County"

 

My nurse yells out he has a pressure of 68/30, pulse 140 sinus tach with occasional runs of trigeminy. I actually remember this part I think to myself... because it was like, the best part. The only cool thing I get to do i think to myself.

 

I crack the ribs, insert bilateral chest rubes, hemo-pneumos. Aight. I set the tubes, my nurses give txa in hopes that we can force the clotting cascade.

We lose pulses, v tach, 1 shock no cpr converts him back to sinus tach 140 with PVCs. I look to my RT, "how you doing with the airway? As I ask that I see a bunch of blood in the suction. 

"Airways all sorts of bad" RT says. I make my way up. Damn. It looks like spaghetti sauce. I have another nurse run for a cric kit and they bring back a surgeon from upstairs with the cric kit.

 

"Dr Bae! You actually did something!!!!" The surgeon says. "Uuuhhh. Yeah. Can you try to cric him while I get him ready John?" John performs the Cric while I establish a central line. I have the nurses continue to stabilize the patient as best as our trashspital can. 

 

A nurse yells, "ALS WILL BE HERE IN 5." 

I talk to John. "Hey, can you manage here for a bit? I'm going to take some nurses and ride in with them to the other hospital."

"Yeahhh no worries, good to see you actually did something for once!!! 😂😂" he laughs, I know he's serious and joking at the same time, but its a compliment and he gives me a hug. 

This massive brand new international cab CCT ambulance pulls up code. Its red and white with a ton of lights on it, and a logo that says "AMBULNS." On the side. As the company name. Thats weird. 

 

They come in and I give them my report. 

"Hey, At this point we have a pressure of 90/42, satting 92% on a vent, pulse 144 with pvcs, bilateral chest tubes, txa on board, central line established and a bloody mess of bandages and tourniquets, we also have a team to ride with you. Let's send it!"

We get him loaded up, fortunately he's light. We all hop in, there's my nurse, me, their nurse, a medic, and another medic driving this giant thing, and we're all cozy on our ride over with our ground beef friend.

[Steve Bae]

I walk around the ER looking at the transients in the waiting room next to people that could be actually be more sick. But then I remember its my lunch break. So, I walk into the waiting room and ask "hey, who wants a sandwich?" all of the transients raise their hand. 

"GET OUT OF MY ER, YOU HAVE NO MEDICAL COMPLAINT. LEAVE OR I'LL HAVE EVERY OFFICER IN TOWN COME AND TAKE YOU OUT FOR ABUSE OF THE SYSTEM YOU TRASHCANS". I then look at the normal people. "we'll be with you shortly, especially now that the system abusers are out. I'll have house keeping bring air freshener, clean it up out here and if you need anything please just ask." 

I walk back into the doctors lounge and grab my turkey blt. 

[D. Callahan]

*i pull into the parking lot and back up to the doors and place the truck in park and pick up the mic and key it up*. 

“ERT Medic 2 Show us Arriving at St Gardena” 

“Copy Medic 2” 

*i release the mic button and clip it into its holder and get out and open the back doors to help Brealin and Sparks get the stretcher outta the back* 

[Steve Bae]

"Hey, who are you? I didn't hear a report on this, what is this?" I look at them and immediately think anaphylaxis. "Did you even give him anything????" they give me the report that they gave epi and oxygen. "WHY DIDN'T YOU GIVE HIM BENADRYL??????????" I send him to resuscitation room 1. I immediately order 0.1 mg epi 1:10,000 iv, 50 mg benadryl, I listen to his lungs and I hear no air movement in the lowers and diminished wheezing in the upper, pulse ox of 80. I also order up succinylcholine and etomidate, and start fluid resuscitation. I also have the nurses bring in an intubation kit just encase there's no improvement in the next few minutes. 

I have the rt push the succs + etomidate, successfully intubate, and the patients sats and vital signs start to rise. I call for an ICU room, and have the RT and nurses monitor him and update me on status changes.

 

I call their dispatch. "HEY, YOUR MEDICS ALMOST KILLED MY PATIENT AND DIDN'T GET ME A REPORT. THEY COULD'VE LOOKED IN THE PROTOCOL BOOK OR GOOGLED IT IF THEY NEEDED IT. I AM DR. BAE, NEVER FORGET MY NAME"

[L. Sparks]

*I look over from the nurse's station extremely confused as Dr. Bae comes barreling in yelling. He shouts his questions and doesn't even give us a chance to answer.

He's yelling so much, and not listening to anything, that he seems to confuse our patient with the sick coughing homeless guy in the hallway bed next to us.

"WHY DIDN'T YOU GIVE HIM BENADRYL??????????"

'We did....' I start, but get cut off immediately by Bae's look of disgust.

The homeless guy is whisked up and moved to resuscitation room 1 where he starts getting all the attention. I decide not to interrupt....there's no getting through to Dr. Bae when he's on one of his "streaks". I watch in horror and interest as he proceeds to RSI the sick homeless guy who was actively dying in the hallway bed. At least he's getting treated now....sort of. Pretty sure that dude had TB or something and not anaphylaxis, but whatever. He probably needed an RSI anyway.

After Bae looks at us in disgust one last time, he retreats to his office to presumably yell at someone over the phone about our incompetence. We hand off our actual patient to a nurse...who's not surprised in the slightest as to what just happened. Just another day at St. Gardena.

Edited July 21, 2020 by Chris07

[Steve Bae]

I fund my own helicopter for the ER, I hire the most expert former special forces pilot decorated with more medals and flown more combat missions than anyone else with a tinge of PTSD at the small salary of 250k a year + bonus per flight, and his co pilot buddy for the same. good deal. I also buy us a decked out brand new rescue blackhawk in all black with a reflective black "St. Gardena Aeromedical" with a black reflective punisher skull on the tail. I also fund us the giant helipad on the ground and take out a chunk of the beautiful scenery with security for the helipad, and get the best construction companies to come in from around the world. and tell them I'll pay them bonus to finish it sooner.

Edited July 27, 2020 by losangelesi