A Doctor's Trust (Lifeline Air Rescue Book 4) by Scott Laura

Author:Scott, Laura [Scott, Laura]
Language: eng
Format: epub
Publisher: Readscape Publishing, LLC
Published: 2019-08-01T05:00:00+00:00

9

“She’s bleeding from numerous sites—her IVs, her nose and mouth.” Concerned, Jenna glanced at Zane. “I don’t understand. Is this a result of something we gave her?”

“No. She’s in DIC, disseminated intravascular coagulopathy. It causes either extreme bleeding or excessive blood clots to be thrown through a patient’s system.”

Jenna wasn’t convinced. “And you’re sure it’s not anything I did?” Just to be safe, she double-checked the ventilator settings to make sure she hadn’t missed something.

“DIC is the result of her sepsis from the amniotic fluid embolus—nothing you did.” Zane’s confident tone reassured her. “Give both units of fresh frozen plasma they sent with us.”

“All right.” Jenna did as he’d asked, although she’d never actually hung fresh frozen plasma before. She knew it was a blood product, though, so she followed the same procedure, wondering if he watched to make sure she didn’t screw up again. But no, Zane took the clipboard from her hand and reviewed her notes, not paying attention to her actions.

“There isn’t much else we can do, except to get her to Trinity as soon as possible.” Zane handed the clipboard back to her, lines of frustration marring his forehead. “So far sedating her hasn’t worked, her pulse ox is still low. The constant bleeding isn’t helping her blood pressure any.”

“Should I increase the drip?” Jenna glanced at the monitor. “Her mean arterial pressure has dropped below sixty.”

Zane appeared surprised. “I didn’t notice—good catch. Yeah, titrate her dopamine until you’re able to keep her MAP at sixty or higher. Once you get the maximum dose, let me know. We may need to start another vasopressor.”

No mistakes this time. She increased the infusion rate on the dopamine, then double-checked the dose. She knew she’d be double-checking herself nonstop now. “I’m at eight micrograms per kilo per minute, but you might want to do the calculations yourself, just to be sure.”

He frowned. “Jenna, I trust you. Stop beating yourself up, I’m sure it’s fine.”

Since he wasn’t going to double-check her math, she did the calculation again using the calculator on her phone just to be sure. It was correct. She stared at the monitor. When the patient’s blood pressure dropped again, Jenna increased the dopamine.

The next few minutes passed in silence.

“I’m at the maximum dose.” Jenna met Zane’s gaze, trying not to show the depths of her concern. “What medication do you want to hang next?”

“ETA five minutes.” Nate’s deep voice broke into their conversation. “Is everything all right back there?”

“We’re fine. Although we’ll be better once we get to Trinity.” Zane nodded at her. “Hang the norepinephrine.”

“Do I need to request a hot unload?” Nate asked.

“No, we’re going directly to the ICU. The medical critical care team is waiting for us.”

Jenna pulled out the bag of norepinephrine, but she couldn’t remember what the normal starting dose was. Her mind went totally blank.

Zane must’ve noticed her hesitation and quickly came to her rescue. “Start at point zero two micrograms per kilo per minute. You can titrate in increments of point zero two from there.

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