Medical matters

Posted on Wed Mar 20th, 2024 @ 6:10am by Zirvell Khen & Commander Peeq Elyro MD

2,121 words; about a 11 minute read

Mission: Mission 1: To Catch a Thief
Location: Sickbay

It was early in the afternoon, school had just finished as Zirvell strolled into the ship's medical facility. He glanced around to make sure there was no ongoing emergency before walking in further, PADD tucked under his arm.

At the same time a fair haired boy with the darkest eyes possible followed only a few steps behind him. The boy paused as a wave of uncertainty washed over him, then reached to touched the other boy. "I don't think you're intruding... you're allowed to be here right?" The boy smiled. "I'm Revan Mercy, you can only be Zirvell."

Zirvell held his breath, this was the first officer's son, surely now he had to tread carefully? "Zirvell," he confirmed. "You here for first aid too?"

Revan nodded, an easy smiled on his face that reached his obsidian eyes. "You don't have to be so nervous around me," he assured the older boy, "I'm here to learn, same as you. I want to be a counselor, like dad. But I have to start somewhere.."

Nervously, the Cardassian glanced around, not having expected company. "I just want to be able to help," he answered quietly. Having his feelings answered to felt a little disconcerting.

Commander Peeq Elyro stepped out of his office in the Sickbay compound, noticing the two youngsters nearby. He had just got off the line with Starfleet Medical Headquarters on Earth regarding the recent opening of the Director of Trauma Surgery for Starfleet. It was an amazing opportunity and he agreed to consider the position. It would be working with one of his personal heroes even, Doctor Katherine Pulaski.

"Why hello there," the doctor greeted. "Nice to see you both."

Zirvell beamed at the man. "Doctor," he greeted, "I believe you know Revan Mercy? He wants to learn too... There was a first aid lesson planned today, right?"

The tall Edosian nodded, collapsing his three hands together as he looked at the youngsters, "I'd be happy to have another with us. How have you all been?"

"Not too bad sir," Revan replied, "just wish dad was home more often.

Zirvell chuckles. "Perils of command? Captain Fredriks is barely home too." He looked towards the doctor. "I'm well sir...I think I'll be alright eventually."

Walking over to the wall unit, the Chief Medical Officer pressed a series of indicators on the control panel and a holographic body appeared on the central biobed. The patient had a laceration on her arm, about twelve centimeters in length. "Our patient has been injured in a small kitchen accident. What should our next step be?"

"That's a big injury for a kitchen accident," Zirvell noted, his smile vanishing. "I'd ask her how it happened first."

"But staunch the bleeding," Revan supplied, "and scan for infection? I've seen dad do that with us..."

The Edosian looked at both, "Interesting ideas. So, I would normally apply modern techniques for treatment which would be?"

Zirvell had no answer to that and he looked to the other boy. "Dermal regenerator," Revan answered smartly, "to stop the bleeding and give her antibiotics just in case."

"Now if I were to apply archaeological medicine techniques to this treatment, what do you think we would do?" This was a harder question.

"Tourniquet," Zirvell answered quickly, "tie it off so blood won't pass. But not for too long or the limb will die, and no loosening it either in between. She'll die for sure then.

"Yes! Excellent!" The doctor answered as he observed. "Once the bleeding is stopped what would be the next course of treatment, prior to formalized medical care at a treatment center?" Some would probably find it odd that he was giving a treatment lesson on archaic medication techniques that were no longer in active practice, but Doctor Elyro was a student of past medical treatments and knew that you did not always have access to advanced technologies. In the modern era when computers could do everything for you it was easy to become complacent. Unfortunately, medicine didn't abide complacency well.

Revan shook his head, he had no idea despite growing up in a medical family.

"I'm not sure," Zirvell answered thoughtfully, "keep an eye on skin colour? Mend the inury as best as we can? Apply a pressure bandage?" He paused. "We can't remove the tourniquet..."

"No you cannot," the Edosian answered directly, "But you are correct in that you would apply a pressure bandage. Allow me to demonstrate. Computer, reset demonstration."

The hologram shimmered and reset back to the default status from when they first began the lesson. The Doctor walked over to a wall sink, "First step is to wash your hands to help avoid infection of the patient. This is important, but you need to determine if the risk to the patient is compounded the longer this takes." Having washed his hands as he spoke, the alien noted in his head he'd spoken for 20 seconds before walking back toward the patient.

"Our next step is to stop the bleeding." Picking up a cloth pad, the Chief Medical Officer continued, "minor cuts will usually stop bleeding on their own, but you can press the wound with a clean bandage or cloth and raise it until the bleeding stops." He lifted the patient's arm as he spoke to demonstrate. He pointed to areas, "Clean the wound as you go, rinsing with water to lower the risk of infection, but being careful not to get soap into the wound as it can irritate the wound. Once complete, put a thin layer of antibiotic ointment to keep the surface moist and help prevent scarring."

"If you have a minor scrape or scratch you won't cover it," Grabbing a bandage, Peeq continued, "As this is a larger wound put on a bandage, rolled gauze or gauze held in place with paper tape to cover the wound to keep it clean. The covering will be changed at least once a day or whenever the covering becomes wet or dirty. Changing this dressing also allows you to watch for signs of infection, which are changes in color, increasing pain, drainage, warmth or swelling."

"But if like the prior example it's arterial...how do you act then?" Zirvell asked, absorbing the information given. "What do I watch for? It shouldn't bleed should it? Or can I remove the tourniquet after applying that pressure bandage? What if we can't treat it, what then?"

"Reset," the alien doctor directed, "update with additionally defined parameters."

The hologram changed as identified to an arterial wound. Doctor Elyro stepped around the patient so that the youngsters could better see, "The first priority with an arterial wound is to ensure that someone gets to a Sickbay compound as soon as possible. You should start by arranging additional help, but if no help is available make the patient sit down and ensure that your hands are sterile - either by washing or glove." The three armed doctor identified as he helped the patient into a sitting position.

"Apply deep pressure to the wound with gauze or a clean cloth, placing it over the bleeding wound, and hold tightly and press down firmly, but not so much that you’re hurting the injured person," the Doctor warned. "Unlike our other example, if there is debris in the wound, don't try to remove it until you're at a medical center. Press down on the wound around the object, not directly on top of it. You may also ask the patient to hold their own cloth to help divert their attention," Peeq said as he helped maneuver the patient's hands. "You can apply additional gauze, if needed, but don't remove the first layer because it could cause damage to the blood clot." The Edosian lifted his finger in warning, "Clotting takes 10 to 20 minutes, but you shouldn't check. You would then apply the pressure bandage to hold the gauze in place. If the bleeding's somewhat under control you may wrap the wound and gauze with sterile bandage wrapping." He demonstrated, "Use one hand to hold one end of the wrapping over the wound at the part farthest away from their heart and use your other hand to circle the bandage around their limb. You should tuck the end of the bandage under one of the strips to secure it and make sure that the wrapping is pulled tight, but not too tight. You can tell if it's too tight if the person's fingers turn blue. If you don't have a bandage wraps you can improvise with a shoelace or other clean cloth."

Demonstrating further, "Now, twist the bandage over the wound to add additional pressure. If needed, you can apply pressure to the artery between the wound and heart by using 2 or 3 fingers to push the blood vessel against the person’s bone. If further help is unavailable or delayed you can improvise a tourniquet with a belt, necktie, bandana, or scarf, so long as it's at least 4 centimeters thick. Place the tourniquet at least 5 centimeters above the wound, between the wound and the heart and clip it into place and tighten it as much as you can until the bleeding stops."

Helping to raise the patient's arm, "If the injured person is able to move, elevate their injured extremity above their heart to help slow the bleeding, but if they have a broken limb, focus on applying direct pressure until the medics arrive. Reassure the patient that they'll be fine but monitor for turning pale or bluish, cold or clammy skin, weak but rapid pulse, dizziness, faintness, or nausea."

Peeq looked at the Cardassian, "I'm sorry but that's a bit longer of an answer than I think you wanted."

"Not at all sir," Zirvell answered brightly, showing the notes he'd been taken. "This is very helpful." He glanced sideways at his Betazoid companion, who had gone very quiet. "Revan?" He queried reaching out to touch him.

Revan had gone very pale, his eyes fixed on the bed with the simulated patient. He knew it wasn't real, he sensed nothing from the 'patient' after all but still he felt very queasy.

"Doctor," Zirvell called, a hint of alarm in his voice. "Revan doesn't look so well and he doesn't react..."

"Syncope is common in people who are experiencing archaeological medicine," the Edosian pointed out. He pulled out a tricorder, "Often medical instruments, needles or even the sight of blood could trigger it." Peeq initiated the scan sequence on the device.

Zirvell leaned closer to see the results, but those were a little beyond his comprehension. "I'm not sure," he confessed as he nudged the Betazoid again. "He seems in shock or something? I don't know..."

Startled, Revan blinked a few times, making an effort to focus on the doctor. "I don't think I'm suitable for this doctor... I don't like blood, it makes.me feel really sick."

Doctor Elyro nodded, "Nothing to be ashamed of. Many Doctors learned far too late that they weren't cutout for medicine. You're ahead of the curve." Realizing that his statement was a little more blunt than he intended, he tried to course correct, "However, you could potentially get used to it."

Revan shook his head. "I doubt it, I never liked being in sickbay even when dad was still a doctor. Mom was a doctor too... dad's parents too, but I won't be. I think... I'm more suited for counseling maybe." The Betazoid smiled. "Follow in dad's other footsteps."

Zirvell cast the other boy a concerned look, hovering close just in case. "Are you feeling any better?" He ventured carefully.

"I'm fine," Revan smiled, sensing the Cardassian's genuine concern.

"Doctor?" Zirvell queried, wanting the CMOs confirmation.

The alien nodded, "Oh I'm contented to agree with you." He glanced at the Tricorder readings, to be on the safe side, and nodded politely. "I think that we've had enough excitement with this lesson for one day. Is there anything else you'd like to discuss before we adjourn?"

While Revan took the opportunity to depart, Zirvell remained. "I want to be a nurse," he declared solemnly, an utterly serious look in his eyes. "I want to learn all you can teach me, if the captain will approve it."

"We can talk with the Captain about that," Peeq agreed, after some time considering. It was a tough decision, to be fair, but he was certain that he would assist so long as the Captain agreed to it.

"Thank you doctor," the boy answered gratefully, "now I probably should take Revan home to his dad. He still doesn't look too great "

The alien voice answered, "Snap to it."

"Yes sir," the boy smiled as he grabbed Revan by the arm and led him out

 

RSS Feed