#Chapter4
Lilian
LILLIAN'S POV
(A/N) Acacia is Lilly’s fake name
/"Morning Acacia/" Ingrid the ever cheery barista greets me.
/"Morning Ingrid, how are you?/" I ask
/"I'm good,/" she says, handing me my coffee. This is the only place I buy coffee and I order the same thing every day so they know what to get me.
/"See you around, have a good day/" I wave as I leave the shop.
I opened the door of my 2015 kia Sportage and put my coffee in the cup holder then got in and drove off to The Adam's memorial hospital where i worked. I park in the employees parking lot grabbing my stuff and head inside the building.
I walk through the glass doors and into the building greeting the receptionist at the front desk in the waiting room as I head towards the elevator. I press the button for the 3rd floor tapping my feet impatiently as the door closes and the elevator ascends. I quietly sip my coffee and rest my bag at my feet.
The elevator stops and the doors open to the surgical ward where I work and I'm greeted with the smile of my best friend Tami who is a nurse here.
/"Morning Tami/" i say stepping out the elevator
/"Morning Acacia, don't bother leaving the elevator we're going down/" she says pushing me back inside
/"Why?/"
/"You're needed in the ER/"
/"I can't be in the ER i have surgeries scheduled today/"
/"That's what i said too but the orders came from upstairs like way upstairs. There was a massive car crash this morning so there's a ton of patients, four of them came in with severe injuries, three are already in surgery but we're one surgeon short/"
/"What about the on call surgeon for the ER/" I ask
/"They can't reach him/"
I let out a sigh as I leaned back in the elevator. So much for having an easy day today, no wonder I hate Mondays.
/"Who are the other surgeons working/" i ask
/"Dr Clarke, Jefferson, Daley and you/" she answers
/"Oh great the dumbass squad/" i complain
/"Don't worry everyone in this building knows you're the best surgeon here/"
/"Thanks Tami,/" I told her with a genuine smile.
The elevator stops at the first floor and Tami and I step out to find the ER in chaos. Nurses and doctors rushing about, the waiting area is filled with patients, just what the heck happened this morning.
/"Dr Simpson thank God you're here there's something wrong with one of the patients, she's having difficulty breathing/" a nurse rushed up to me.
/"What's wrong with her?/" I asked as we hurried into the patient's room.
/"I have no idea, she was fine the last i checked on her then all of a sudden she just started gasping for air and saying she couldn't breathe/"
We rush into the room to see a pregnant woman on the bed gasping for breath. I quickly grabbed a pair of gloves and my stethoscope before rushing over to the patient assessing her. I noticed the rate of her heartbeat was higher than normal so I asked her if she was feeling any chest pains. When she barely nodded before throwing up on the floor, I immediately picked up on what was happening.
/"Please lay back, miss,/" I told her.
/"Tami grab me a 16 gauge syringe/"
/"Do you know what's wrong with her doctor?/" The panicking nurse asks
/"Her larynx has shifted and she is suffering from tension pneumothorax/" I tell her.
/"Holy shit she's not breathing/" Tami yells handing me the needle
/"That's because her lungs has collapsed and her heart is being pushed into her chest cavities/"
I quickly Uncapped the needle and inserted it into the second intercostal space in the midclavicular line of her chest at a ninety degree angle. I slowly pull up the syringe draining the fluid from the patient's lungs, she immediately gasps for air as she begins breathing again.
/"Whoa that was incredible/" Tami says in awe watching the lady starting to breathe on her own.
/"It was nothing, any doctor could have done it/" i shrugged
/"She is able to breathe now so she should be fine but keep an eye on her in case anything else arises in fact just to be safe give her a full body examination and run a few tests/".
The nurse nodded before grabbing the patient's file and heading to the exam room to do what I asked.
/"Ok, where's my patient?/" I ask Tami, pulling off the gloves and disposing of them.
She led me further down the hall where the porters were pushing a man into the operating room. Doctor Daley looked up and saw me coming towards them, he stopped as we caught up to him.
/"Where the hell were you, Simpson? We've been waiting for you to start this man's surgery for half an hour!/" he shouts.
/"Excuse me? I'd advise you to watch your tone doctor Daley/"
/"If memory serves right which it does, I am scheduled for two heart surgeries one at 12 and the other at 4 pm. My shift starts at 10:30 am and I got here at 10:00 am which is when I was made aware of this surgery so don't you dare act like you want to come at me. I may be the youngest surgeon here and you may have worked here longer than I have but in case you forgot you’re not my boss so if you'll excuse me i need to go scrub in for surgery/" i say pushing past him with Tami beside me
I quickly and carefully washed my hands before putting on my PPE'S before heading into the operating room to begin the surgery
Two hours later I was able to walk out of the OR, my surgery had gone well and thankfully the patient is no longer in a critical condition. After cleaning up I went back to check on the pregnant patient from earlier. I found her resting peacefully so I decided to take a look at her file. I saw that she was one of the patients from the ten pile car crash this morning. It seems my assumption was right since she suffered from a tension pneumothorax.
A tension pneumothorax develops when air progressively accumulates under pressure within the pleural cavity. If the pressure becomes too great, the larynx shifts to the opposite hemithorax and this causes compression of the contralateral lung and great vessels. When the syringe valve is released air is gushed out but since the lady vomited fluids ending up in her lungs which caused her to stop breathing.
Tension pneumothorax can be caused by poisoning, injuries or underlying lung conditions. She didn't show any signs of being poisoned and I didn't have the time to check her file for any underlying illnesses so I assumed it was caused by the injuries sustained in the car crash which is why I came back to check.