"I get paid the same holiday or not."
"Which is more than me and much much better than your poor residents."
"They do have the worst of both worlds. Bad pay and their shift doesn't end at twelve hours like yours." The peds residents took a holiday split shift call schedule over Thanksgiving, Christmas, and New Years. They shuffled the residents around so everyone got three days off in a row. During Christmas and New Years, they'd get a full week each.
Avigayle was off for her brother's wedding while Clarissa was covering the PICU since interns didn't rotate till the second year. The only place more depressing in Pediatrics than the PICU was heme-onc.
Then again, Clarissa was scheduled for heme-onc in December, so it could get more depressing. She and Clarissa could be depression buddies.
"I have dispatch. Rescue Alpha transport reports four ambulances en route and need an ER attending," the ER desk clerk interrupted their conversation.
Dr. Gupta-Carver, the ER Chief, took the phone and paled under her tan skin. It wasn't a surprise considering the Trauma pod only had two ER attendings today and two other attendings were supervising the two other open pods. Most people avoided the hospital for the holiday and paid for it later.
Not today, because Dr. Gupta-Carver steeled herself and started marshaling her troops. "Prepare Trauma 1, 2, and 3 for two pediatric and one adult hydrocarbon exposures with full decon. Victims were inside a gasoline tanker at the railyard. Set up decon stations in each trauma and anticipate hypothermia treatment."
"The fourth ambulance?" Dr. Ryan Yates, a White guy in glasses and her fellow attending, asked.
"Curtains in this pod. They've already been decon'ed, but we might hose them down a few more times. Call PICU and have them send down someone for Trauma 1 and 2."
The ER residents and nursing staff started dividing themselves into groups next to the doctors’ workroom, called the FishBowl.
The clerk called out, "PICU says they're in the middle of a code upstairs. Keep them updated, and they'll be by as soon as they can."
Gupta-Carver's gaze fell on Lillian. "Can you stay?"
She wouldn't have asked if she didn't need the help. "I'll help till PICU arrives."
The first few minutes would be resuscitation and securing airways. Complex management of inhaled hydrocarbons would fall to the PICU.
Mentally finding her inner calm, her mind flashed to three years ago. The three of them, Yates, Gupta-Carver, and herself, had been here together. She'd been an intern then. She'd been scared, frightened, and she’d carried a little bit of that inside ever since.
But not anymore. If the last few weeks had taught her anything—other than ask your lover if he's secretly a Spanish speaking Irish police officer—it was that she did have a tiger inside.
Two gurneys with two sets of female paramedics rolled in at the same time.
"Jerrell and Ray, both ten years old. Explored inside of a gasoline tanker railroad car. Submerged for unknown amount of time."
The two boys stank of gasoline, and probably should have been dead… except they were sitting up looking around past their oxygen masks.
“I'll take that one.” She pointed to Jerrell who had dyed purple hair and followed him into Trauma 2.
"I'm Dr. Hernandez. Give me the update."
“They went exploring in the railroad by their house and fell in a tank car. Weren't really breathing when the firefighters got them out. We stripped their clothes and put them on oxygen."
"You didn't do a decontamination wash?"
"No. We were so happy they were conscious and breathing we didn't dare wash them off in the cold. If we'd made them hypothermic…"
The kids were lucky to be conscious, and hypothermia could have pushed their already sensitive hearts into ventricular fibrillation. And shocking someone covered in gasoline was a bad idea.
"Okay, thank you. We'll take it from here."
The blonde paramedic nodded, "Okay, two more ambulances are behind us with the firefighters. I'll head off to decontaminate the inside of our rig."
With the paramedic gone, it was up to Lillian to run the show, and fortunately she knew exactly how to treat hypothermia. "All right, I need several liters of heated normal saline. We're going to wash his hair and his body right now. Then portable chest x-ray and non re-breathier mask humidified oxygen with albuterol neb."
"Understood," said the closest ER resident whose name she didn't know.
