#smerSim: Mike

[san-myshuno-er]

Mike: He’s in V-fib!

Quinn: Damn it! We’re intubating, get me a size 8 tube and french blade! 5mgs of Epi! And where is Brad!?

Brad the Intern: Here, Ma’am!

Quinn: What do I have to remember for the intubation again, Brad?

Brad the Intern: After positioning the head, you, uh… tilt it, and… uh… open the mouth, and- uh…

Quinn: Faster, Brad, I know you know it!

Brad: You place the blade, avoid the teeth and the lips, and advance the blade until you see the epiglottis, push the blade to the left, lift, visualize the chords and pass the tube into the trachea.

Quinn: Excellent. We’re in. Bag him. Brad, start CPR. Where’s that damn crash cart?!

Mike: Still V-fib!

Quinn: Is the epi in already?

Mike: Yeah. No effect.

Quinn: Alright. Charge to 200.

Nurse: Charged!

Quinn: Clear!

(patient gets shocked)

Mike: No change.

Quinn: Charge to 300! Clear!

-----

Jenna: *snores*

(Door opens and paramedics come in with a patient, waking Jenna.)

Paramedic (to doctor): His head apparently hit the steering wheel on impact, and there was also a lot of glass at the scene, although in our rig we couldn’t see any that might-

Jenna: Oh my! Good morning…

----

Shawn (to Doctor Manchin): No sensation radial, median or ulnar, no pulses, temperature and color as you see, we elevated it, he’s gotten 500 ccs of saline by push, crit’s 30 to 5, he’s been sent for typing and cross matching; X-Ray is waiting and the OR says they’ll have a room for you in twenty minutes.

Dr. Manchin: Okay. Let’s get him out of here.

Shawn: Listen, you think you can keep that hand?

Dr. Manchin: It looks pretty good. I think so.

Shawn: That’s good. I told him you’d keep it for him. He’s counting on you.

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[san-myshuno-er]

Quinn: Canelli? Anyone here from the Canelli family?

Timothy Canelli: Yes, over here. I'm his son.

Quinn: Let's go over here, Mr. Canelli.

Mr. Canelli: My father... he's here?

Quinn: (quietly) As you know, Mr. Canelli, your father was in an accident this morning. If you would come with me...

Mr. Canelli: (loudly) No! Tell me, god damnit, tell me right now!

Quinn: (whispers) I'm very sorry, Mr. Canelli, as a result of the accident, your father had several heart attacks, until his heart stopped. We tried to revive him for almost an hour, but we were unable to-

Mr. Canelli: No... no... you're lying... you're lying... he cannot be dead...

Quinn: I'm very sorry, sir, but-

Mr. Canelli: ... you're sorry!?

Mr. Canelli: You bitch! You bitch, you fucking bitch, don't say that! My father! What are you bitch... damn... it can't be...

Quinn: Mr. Canelli, please stop! I'm so sorry, but he is gone. And he wouldn't want you doing this!

Mr. Canelli: Gone... he's gone... oh God...

Mr. Canelli: I'm sorry, Dad... I'm sorry, Doctor, please forgive me... I'm so sorry... I'm sorry... (crying)

Quinn: It's okay, Mr. Canelli... It's okay. It's going to be okay... Why don't I take you to him?

Mr. Canelli: Okay... thank you...

Quinn: (joins the others) Are there any others? I thought several more were coming?

Mike: No, that's it.

Jenna: What?! That's it?

Mike: Yeah. Last two were D.o.A.

Quinn: So that's it.

Eric: Yeah. For now. ... Quinn, can I speak with you before I go up?

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[san-myshuno-er]

Shawn: Alright, here we go! Let's get this gentleman to Trauma 2.

Cam Landry: What's your name, Sir? Sir, can you tell me your name?

Patient: It's Wilson.

Shawn: Okay, Mr. Wilson, I'm Dr. Jones, this is Nurse Cam, and we're going to take very good care of you.

Mike Davis: What's your name, sir?

Patient: It's Canelli. George Canelli.

Paramedic: Suspected MI, 500cc of Saline are in. Slight head trauma, he must have hit his head on the steering wheel.

Quinn: Alright, Mr Canelli. I'm Dr. Roe, let's get you down to Trauma 1.

Mr Canelli: Could someone perhaps call my son and daughter? I was... (heavy breathing) on my way to my son's house to see my grandchildren...

Quinn: Of course. Why don't you give the number to Nurse Mike here, he'll see to it.

Mr Canelli: (chuckles) men are nurses, and women are doctors...

Quinn: It's a changed world, sir.

Quinn: Alright, let's have a listen.

Mike: Pulse Ox is 97, BP is 117 to 87. Pulse is 135.

Mr. Canelli: That's not so bad, is it, Doctor?

Quinn: Sir, if you speak I can't hear your heart. I hear some crackling there. Let's get a EKG, CBC, Chem-7-

Mr. Canelli: What's that?

Quinn: Some blood tests, we look for your blood urea nitrogen, carbon dioxide, creatinine, glucose, chloride, potassium, and sodium values. Other than that, I want cardiac enzymes and, just to be safe, a cross table head and chest X-Ray. Once we get those back, we'll know more.

Mike: First saline is in.

Quinn: Good. Let's see what those tests say.

Shawn: Okay, let's have a looksie. Lights, please! Oh wow. Have some nice and pleasant thoughts, sir. (to the nurses) Let's have a CBC, type and cross-match. We got a pre-op here... Notify the OR, we need a room.

Cam: It's not completely severed, is it?

Shawn: No... still some attachment left. That's a good sign, sir.

Shawn: Call Vascular and Orthopedic. Tell them to get down here right now. This is their lucky day! Mr. Wilson, your hand is barely attached, but it's gonna be okay. Get me an EKG and an X-Ray of his wrist and hand... can you feel anything in your hand?

Mr. Wilson: No...

Shawn: We'll save your hand, don't worry.

Quinn: Mr. Canelli, we are going to call Cardiology as soon as those tests are back, and then they can decide what kind of treatment you might need.

Mike: Quinn, pulse ox and pressure are going down!

Quinn: I'm losing his pulse; Mr Canelli? Mr Canelli?!

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(sorry this post took so long!! real life got into the way...)

[san-myshuno-er]

Paramedic: ... about 3 liters at the scene.

Dr. Eric Tanner: Okay. Curtain 4, let's go.

Jenna: Do you need a hand, Dr. Tanner?

Eric: Dr. Kaminski, what are you doing here? According to my schedule, you're not on right now.

Jenna: I was here anyways and thought I could help out, but if you don't need me, I'll-

Eric: No, no. With me, with me.

------

Dr. Manchin: Shawn, you're a smartass. You'd like to do this case yourself, wouldn't you?

Shawn: I could do it. Yeah. I feel strong. I feel ready. I could do it, yeah.

Dr. Manchin: You're just a third year resident, Shawn. You're years away from a case like this. Hyper down.

Quinn: Clear!

Mike: No changes, still v-fib.

Quinn: How long has it been?

Mike: 47 minutes. ... Hey, Buddy, are you sure you don't want to switch?

Brad: Positive. I want to see this through until the end.

Mike: You must be exhausted though.

Brad: I'm fine.

Quinn: When was the last epi?

Mike: 7 minutes ago.

Quinn: Alright, that's it.

Brad: Wait, there's still a chance!

Quinn: We've been shocking him for almost an hour. Even if we got him back somehow, his brain is fried. Hold CPR.

Quinn: Time of death: 11.27.

Mike: God, damnit. He didn't seem too bad when he came in.

Quinn: Yeah.

Mike: ... I'll go see what else is coming our way.

Quinn: You did good there, Brad.

Brad: I had hoped I could save my last patient.

Quinn: We did everything we could for him. We're not Gods, and he coded before we could even alert cardiology. It was... bad luck.

Brad: Does it ever get easier?

Quinn: Some. But not a lot. ... You'll be a good doctor, Brad. Don't feel defeated.

Brad: But not a good Emergency Doctor.

Quinn: You don't have to be... I'd be a lousy dermatologist. (smiles) Why don't you just go home? It's your last day, I handed in your evaluation last week, and I'm sure you have laundry to catch up on before you start your next rotation.

Brad: If you don't mind?

Quinn: I don't. You were a good student, you deserve it.

Brad: Is there nothing I can do for you before I go? Charts, labs?

Quinn: You could get me my crutch from the lounge, but other than that... no.

Brad: Alright, Ma'am. Thank you.

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