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Just There to Help
The sun began to set, displaying a horizon of extravagant colors across the sky. Red, orange, and yellow clashed together to make a beautiful sunset in the distance. Walking down 54th Street, Paul stopped to find the closest diner around as the time had just turned six. Paul was coming home from another late night at the Penn State Medical Center, where he was asked to review a patient’s records prior to surgery the next day. The senior resident had asked Paul to be prepared for tomorrow. Paul was just a medical student yet he was assisting on his first surgery tomorrow. Around the corner, the block glowed from the neon sign that read “Queen’s Diner.” Paul decided to stop in and settle down for a bite to eat. Crossing the street, Paul nearly fell as he did not notice the pothole.
He opened the glass door, walked to the front counter and asked the tall blonde waitress, “May I have a table for one please?”
“Right this way,” responded the waitress grabbing a single menu from the countertop. Paul came to a two seat table where he faced the television to watch the Yankees play the Red Sox. The menu was laminated to prevent stains, but many noticeable creases still retained the ketchup from previous meals.
Flipping through the menu, Paul headed straight to the “Wraps” section and asked the waitress to take his order, “Hi, yes, I would like a Buffalo chicken wrap and a Sprite with no ice please.”
“Okay, give it about ten minutes for the wrap and I’ll have your Sprite out in a moment,” responded the waitress, shoving the notebook back into her pocket.
Paul reached into his book bag and took out a textbook and began to flip to the page that was earmarked. The textbook was six inches in width and was titled “Anatomy and Physiology of the Cardiovascular System.” Just as the Sprite was arriving at Paul’s table, a frantic shrek came from the table behind him. Turning around, Paul could see everyone’s eyes locked on a middle-aged woman.
The woman was distraught and yelling, “Someone help my husband. He just fell down.” A man no older than fifty-five laid sprawled on the square carpet.
Paul quickly ran towards the table and knelt down next to the man, “Sir, can you hear me? Can you hear me?”
Paul began to feel his chest up and down, before stopping and thinking for a moment. What could this be? What could this be? Moving his hands up towards the neck, Paul realizes the patient presents enlarged jugular veins. What could this be? He has Jugular vein distention, but what am I missing> Paul's mind began to compile all the different medical possibilities. The book what did the textbook say. Jugular vein distention, but what else. Paul quickly stripped the man's flannel shirt and noticed the right side chest was caved in. Jugular vein distention and unsymmetrical presence of the chest. It … it has to be a tension pneumothorax. Given these circumstances, it’s has to be a tension pneumothorax.
“I’m going to need the biggest needle you have in here as well as at least three feet of tubing. Also, a bottle. A glass soda bottle can do,” directed Paul to the closet waitress whose name tag displayed “Nancy”.
Nancy began to make her way past the numerous bystander. Shortly after, she came back with what was requested; she handed it to Paul. Paul quickly began to align his equipment accordingly to use. The needle is about seven inches long. It’s enough to hit the 2nd intercostal space, so the needle can decompress the air in the pleural space. Paul palpated his hands in between the inferior portion of the second rib and the superior portion of the third rip. Finding the correct spot, Paul slowly punctured the skin and led the needle straight down.The needle came in four inches before a gush of air rushed out of the wound and Paul immediately stopped. The air from the pleural space is leaving. What do I need to do. The book it said … I need to make a one way valve so the air only comes out. Grabbing the tube and the bottle, Paul dumped out all of the liquid inside onto the adjacent carpet of the diner floor. Paul took a deep breath before inserting the tube into the wound where the needle was. Measuring the tube to four inches length, Paul stopped inserting the tube so that it would not continue and hit the lining of the lungs possibly puncturing it. He quickly grabbed the bottle and fed the other end of the tubing into the bottle. C’mon breathe, he urged the man. Breathe, God damn it! Suddenly, a gasp of air came from the patient, and Paul could see adequate chest rise and fall. I did it, I really just did that.
“Did you call an ambulance?” asked Paul as he proceeded to clean the incision area with a sterile cloth.
“Yes, but did you save him?” questioned the waitress bending over him.
“For now, but he needs surgery,” Paul answered as he reexamines the airway.
A eruption of clapping came from the crowd as each bystander was looking at Paul.
Paul got up and sat back at his table, before asking the waitress, “How much longer for the wrap?”