either nodded or his head just bobbed in sync with his desperate breathing. I had no time to sort out which.
I took the laryngoscope from the respiratory tech’s outstretched hand, aware of its sobering weight. Enrique didn’t fight as I eased his head back into the “sniffing position” on the stretcher. I opened his mouth and slid in the laryngoscope’s blade. When I pulled his tongue forward with the device’s handle, the sight of a pulsing red glob of tissue met my eyes. As I’d feared, the expanding aneurysm had pushed his normal structures out of the way. All I could see was the relentless pinkish mass.
Sweat beaded on my brow. I repositioned the blade to my left and pulled harder. Enrique groaned in response but his head held still. I caught a glimpse of white—not the usual “pair of white running shoes” view of the vocal cords, but enough to orient me.
Afraid the streak of white might disappear like a ship in dense fog, I barked to the respiratory tech: “Tube!” She slapped the clear snorkel-like device into my right hand. Without waiting, I snaked it into the mouth and aimed it for the white patches. I had to rock the tube slightly before I felt the reassuring thuds of the tracheal rings as it glided down his windpipe.
Enrique coughed, and the sound whistled from the tube, confirming that it was in the right location. Even before the tube was attached to the ventilator, his breathing quieted and his chest relaxed because he finally had an unobstructed passage to breathe through.
While the respiratory tech taped and stabilized the tube and attachments, I turned to Juan. “I want to have a look at his neck wound.”
Juan frowned. “You sure?”
I nodded.
He hesitated and then slowly peeled his hand off Enrique’s neck. A few inches below the angle of his jaw, the skin swelled out like a baseball cut in half. In the center, a tidy incision, no more than a half an inch, cut horizontally across his neck. A drop of blood oozed from the base of the laceration as the wound throbbed in rhythm with the baseball below it.
I glanced at Juan. “Okay, you can put your hand back. Meantime, Grace, let’s get a pressure dressing on the wound while we transfer him up to the OR.”
Before either could respond, a geyser of blood erupted from Enrique’s neck. I stumbled back as it hit me square in my upper chest and splattered my face mask.
“Resume pressure!” I yelled.
Juan’s hand slapped noisily against the patient’s neck. But even with the aid of his other hand, he had trouble holding his grip. The blood swelled between his fingers and cascaded over the top of them, making the skin of his neck as slippery as ice.
“Blood pressure is falling!” Grace said.
Enrique’s eyes rolled back in his head. I knew he didn’t have enough blood reaching his brain to maintain consciousness. “To the OR now!” I shouted. “Let’s go!”
Someone unclamped the brakes to the stretcher. As soon as I heard the click, I shoved the stretcher and hurtled it toward the door. The staff fell into a well-choreographed routine, moving IV poles, bags of blood, and the ventilator in step with the stretcher. We sprinted as a group for the end of the hallway.
At the doors of the surgical suite, Juan shouted, “I’ve lost the pulse!” Like a pole-vaulter, he hopped onto the stretcher. Knees straddling Enrique’s chest, Juan knelt over the patient and began urgent chest compressions.
The surgical team met us at the door. “Okay, we’ve got it from here,” the anesthetist said as he moved into my spot and assumed control of the stretcher. He tapped me once on the shoulder to let me know my job was done. He turned to his OR nurses. “Let’s get him in the room!”
Nodding, I took a step back and watched as the stretcher was wheeled away. With Juan still riding Enrique’s chest, the procession soon disappeared behind the operating room’s closing doors, but I knew they were fighting a battle that was already
I took the laryngoscope from the respiratory tech’s outstretched hand, aware of its sobering weight. Enrique didn’t fight as I eased his head back into the “sniffing position” on the stretcher. I opened his mouth and slid in the laryngoscope’s blade. When I pulled his tongue forward with the device’s handle, the sight of a pulsing red glob of tissue met my eyes. As I’d feared, the expanding aneurysm had pushed his normal structures out of the way. All I could see was the relentless pinkish mass.
Sweat beaded on my brow. I repositioned the blade to my left and pulled harder. Enrique groaned in response but his head held still. I caught a glimpse of white—not the usual “pair of white running shoes” view of the vocal cords, but enough to orient me.
Afraid the streak of white might disappear like a ship in dense fog, I barked to the respiratory tech: “Tube!” She slapped the clear snorkel-like device into my right hand. Without waiting, I snaked it into the mouth and aimed it for the white patches. I had to rock the tube slightly before I felt the reassuring thuds of the tracheal rings as it glided down his windpipe.
Enrique coughed, and the sound whistled from the tube, confirming that it was in the right location. Even before the tube was attached to the ventilator, his breathing quieted and his chest relaxed because he finally had an unobstructed passage to breathe through.
While the respiratory tech taped and stabilized the tube and attachments, I turned to Juan. “I want to have a look at his neck wound.”
Juan frowned. “You sure?”
I nodded.
He hesitated and then slowly peeled his hand off Enrique’s neck. A few inches below the angle of his jaw, the skin swelled out like a baseball cut in half. In the center, a tidy incision, no more than a half an inch, cut horizontally across his neck. A drop of blood oozed from the base of the laceration as the wound throbbed in rhythm with the baseball below it.
I glanced at Juan. “Okay, you can put your hand back. Meantime, Grace, let’s get a pressure dressing on the wound while we transfer him up to the OR.”
Before either could respond, a geyser of blood erupted from Enrique’s neck. I stumbled back as it hit me square in my upper chest and splattered my face mask.
“Resume pressure!” I yelled.
Juan’s hand slapped noisily against the patient’s neck. But even with the aid of his other hand, he had trouble holding his grip. The blood swelled between his fingers and cascaded over the top of them, making the skin of his neck as slippery as ice.
“Blood pressure is falling!” Grace said.
Enrique’s eyes rolled back in his head. I knew he didn’t have enough blood reaching his brain to maintain consciousness. “To the OR now!” I shouted. “Let’s go!”
Someone unclamped the brakes to the stretcher. As soon as I heard the click, I shoved the stretcher and hurtled it toward the door. The staff fell into a well-choreographed routine, moving IV poles, bags of blood, and the ventilator in step with the stretcher. We sprinted as a group for the end of the hallway.
At the doors of the surgical suite, Juan shouted, “I’ve lost the pulse!” Like a pole-vaulter, he hopped onto the stretcher. Knees straddling Enrique’s chest, Juan knelt over the patient and began urgent chest compressions.
The surgical team met us at the door. “Okay, we’ve got it from here,” the anesthetist said as he moved into my spot and assumed control of the stretcher. He tapped me once on the shoulder to let me know my job was done. He turned to his OR nurses. “Let’s get him in the room!”
Nodding, I took a step back and watched as the stretcher was wheeled away. With Juan still riding Enrique’s chest, the procession soon disappeared behind the operating room’s closing doors, but I knew they were fighting a battle that was already
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