Critical Judgment (1996) by Palmer Michael

Author:Palmer, Michael [Palmer, Michael]
Language: eng
Format: mobi, epub
Published: 2011-03-18T05:11:38+00:00

The overhead page was continuing to broadcast the location of the code ninety-nine as Abby sprinted down the hall to the stairway. The radiology department was on the ground floor, not far from the ER. She tried to recall what doctor from her ER group was on the schedule for today. Whoever it was would certainly be there running the code. Just as she raced through the open doors to radiology, she remembered that the ER doc on duty was Jill Anderson. And that, she knew, could mean trouble. Jill was skittish and insecure, and prone to bursts of temper. Talk about impaired critical judgment! Abby had wondered more than once what Jill was doing in a specialty that required nothing if not a cool head. She was a disaster waiting to happen every time she put on her clinic coat.

A technician stationed by the doors pointed down the brightly lit corridor.

"The MRI suite, Dr. Dolan!" she called out. "Please hurry!"

The magnetic resonance imaging suite consisted of a small waiting/reception area, a dressing room, and the room housing the massive MRI unit itself. The code ninety-nine was being conducted in there. Several people, including two nurses, were standing outside, craning to see through the thick glass walls.

"Just bump someone out and go right in," one of them said.

Over her years as a med student, resident, and then emergency specialist, Abby had been involved in hundreds of code ninety-nines. But the bizarre scene in the crowded MRI room was one she would never forget. Jill Anderson, tears streaming down her face, muttering to herself, was fumbling with the equipment to do a subclavian IV insertion in a woman who was kicking and flailing her arms about desperately. Every bit of the patient's skin that Abby could see was flaming red. Standing across from Jill, Dr. Del Marshall, a radiologist in his sixties, was trying to ventilate the patient with a black Ambu breathing bag. Even from the doorway Abby could tell he was doing an ineffective job of getting air into her lungs.

"What's up?" Abby asked as a nurse stepped back to give her room by the stretcher.

"Anaphylactic shock," Jill said. "She went into it while she was inside the MRI cylinder. Her jaws are clenched too tightly to get a tube in. She's hardly breathing."

Why in the hell didn't you wheel her out of this closet and back to the ER? Abby wanted to scream. The forty-five seconds or so that such a move would have taken would have been repaid a thousandfold with the space and equipment at their disposal in the ER. Now Abby couldn't tell if time was too precious for that.

She moved behind Del Marshall to get a better look at the patient, and at what the radiologist was doing. Above the black rubber face mask, she saw the patient's bright-red hair. Marshall backed away and let Abby handle the breathing bag. She lifted it from the woman's face. Lying there, her eyes wide with panic,

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