Steve pulled into the ambulance bay at the hospital, shutting off the lights and siren. He hurried to the back of the truck, where Mike had everything unhooked and ready to go. They pulled the stretcher out of the back and wheeled her into the ER. They wheeled her into Trauma 1, where the team was waiting. The backboard was moved from the stretcher to the gurney, and suddenly people were everywhere. Techs were drawing blood, hooking up oxygen, and preparing to take x-rays. The doctor was beginning his own examination while listening to Mike give his report on what happened. The doctor started removing the straps from the backboard. A tech held c-spine as Megan’s head was untaped. Efficiently, Megan was logrolled onto her side, the backboard and clothing removed from behind/under her, and x-ray boards positioned in their place. The doctor was carefully running her spine under his fingers. He stopped at an area of bruising on her upper thoracic spine.

“Meg,” he said, talking to the x-ray tech, “be sure to get a clear picture here. I think this is where she impacted the floor.” Megan was logrolled back onto her back. X-rays were taken, the boards removed, and the doctor continued his exam. A nurse inserted a Foley catheter while another tech brought over a small ultrasound machine. The doctor looked at her abdomen via ultrasound to make sure there were no areas of internal bleeding. A nasogastric tube was inserted. The doctor was concerned about Megan’s level of responsiveness. He ordered a CT scan of her head and thoracic spine. It wasn’t until he had the results back that he diagnosed what was wrong.

Steve and Mike had had to return to duty after dropping Megan off, but they had gotten another call soon after returning to base, so were back at the hospital with that patient a couple hours after bringing Megan in. Mike spotted the doctor and approached him. “Hey, Dr. Blake. How’s Megan?”

Dr. Blake nodded at Mike. “She’s still in Trauma 1. I just got the results of her cat scan. Let’s go in so I can show you.” He led Mike and Steve into Megan’s room. Megan had been cleaned up by now, and was in a hospital gown and covered by warm blankets. She still had a C-collar on, and a myriad of wires and tubes were connected to her. Her eyes were closed and she didn’t respond to their entrance. Mike glanced at the telemetry screen above her bed that softly beeped reassuringly.

“She’s resting comfortably at the moment. We’ve given her some pain meds, and are working to keep her blood pressure more stable. Let me show you her films.” He motioned to a light box on the wall. He studied and sorted films for a moment, and popped two into the clips, turning the boxes on. “Here’s where I think the point of impact with the floor was. She has a hairline fracture to this vertebra, and another here to this one. I haven’t noticed any neurological diminishment so far, but I’ll know more when she wakes up.”

“Has she woken up at all?” asked Steve.

“No, she was still very out of it, only moaning and crying before we gave her some Demerol. Her head CT scan came out clear, so I’m thinking that it’s a combination of shock and a bad concussion. She has a nice bruise on the back of her head.” Dr. Blake nodded.

Mike sighed heavily. “So what’s the game plan for her?”

“We’re going to get her into a brace that she’ll probably be in for a couple of months while those fractures heal. I have a neurology consult put in for the concussion. I’m just waiting on a Neuro ICU bed to come available. I’ll have the nurse call you when she gets moved, so you’ll know the room number.”

Mike nodded. “Thanks doc. If she wakes up, tell her we were here?”

Dr. Blake nodded. “We’ll take good care of her. Don’t worry.”