Lt JG Trovek Arys - Amputation

[+ Vitor S. Silveira]

Medical sims can be a challenge. Specially one like this. But again @Arys proved to be a talented writer. 

Reader discretion is advised as you can see from the title. 

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((Cargobay, Deck 17, USS Rahuba))

Being a Lieutenant Junior Grade and a medical officer, Arys found that people often reacted surprised when she disclosed her years of medical experience. Most of the time said experience was an impressive advantage - as long as what she was dealing with something she had experienced before, or that she could relate to a prior experience. 
On the other side it also meant that medical school was quite some time ago. Around eight years to be precise, and it was about the same time since she had last done, or witnessed, an amputation. As an OB-GYN, it rarely came up. 

Would Arys have more trust in the other medical staff aboard the Rahuba, she might have asked someone else to do the procedure. But the most recent mission and the resulting trust issues only solidified her sense of ownership. The Andorian - whatever her name was - was *her* patient. And failure wasn’t an option. 

Trovek: Are the containers secured? 

Tito nodded, forcing himself to control his breathing. He had been running up and down Cargo Bay to make sure none of the containers moved and crushed them.

Tito: They are the best that I could… Unless we are shaken more violently, or hit by weapons they won’t budge.

Arys nodded. By their luck that would happen, but she decided that the best course of action was to stay positive. 

Trovek: And what about the emergency transport? 

Tito: ::Shaking his head.:: Still down, no ETA on their repair yet.

Well wasn’t that just great. This ship was doomed. They would die, and it was all Sal Taybrim’s fault. Arys sighed. Blaming someone made her feel slightly better about this.

Trovek: I’ve sent for medical supplies. As soon as they arrive, we can get started. 

Tito: I am ready to assist.

Tito turned his head when the cargo bay doors opened to announce the arrival of the medical supplies. With them came a doctor Arys had spoken to but not dealt with before. Ayala. She seemed like a pleasant person, but right now all that mattered to Arys was another doctor on the scene. 
 

Ayala: Status of the patient?

Trovek: The Lieutenant is stable for now but there is quite some, I gave a sedative. Scans show that the affected limb isn’t salvageable ::She showed Ayala the scan of what was left of the foot and leg:: It’s why I optioned for am on-site amputation. Necrosis is already spreading, I don’t want to delay further unless you have a better idea. 

The new Doctor nodded and passed over a sonic sterilizer. Well, that was answer enough. Arys made sure she was as scrubbed in as possible, commanding the computer to supply additional visibility by raising the lights. The Andorian was sedated, the metabolism and blood flow slowed, and the area sterilised. 

Trovek: Status? 

Ayala: Prepped and ready.

Arys nodded and took a deep breath, once more mentally going through the procedure she was about to perform. 

Trovek: Give me a ten-blade. 

Ayala: Scalpel.

She handed the scalpel to Arys, who circumferentially incised the skin down to the fascia - a band of connective tissue beneath the skin that stabilized the muscle beneath. In Andorian those had several layers, and Arys was careful to cut through each of them independently to make up for their varying thickness. 

After that, the muscles were further divided, though the progression halted. 

Trovek: I need another pair of hands here. 

Tito: What do you need me to do? 

Trovek: There should be haemostats - clamps. Doctor Ayala can get them into position, you just need to hold them. And don’t stand in the light, I need visibility. Come over here. 

Tito nodded and moved, and Arys watched the other doctor place the tool to control blood flow of the anterior tibial artery. In the meanwhile, Arys made two lateral cuts, working herself through skin and muscle once more. 

Once Arys had double checked the placement of the clamps, she continued her work, closing the blood vessel so Tito could let go.

Tito: OK, anything else I can help with?

Trovek: Check our patient, make sure she is still sedated. Andorian have a high metabolism, check brain activity in particular. 

Ayala: response

Tito: Then let’s save the Lieutenant’s life.

Arys nodded. After the bone was freed from the frontal tissue, surgical tools were changed so the two doctors could disconnect the bone. Soft tissue was pushed to the side, allowing for better visibility until, eventually, the Lieutenants upper leg could be lifted away from its lower half. What remained was a flap of skin that had covered part of the woman’s calf, and which would be used to cover the stump to protect the nerves endings and blood vessels they had been forced to cut through.

They weren’t a moment too soon, as Tito, who monitored the Lieutenants vital signs, spoke up.

Tito: response

Trovek: Understood. I need to close up here, are the transporters back online? 

Ayala: response

Trovek: ::hissing:: Then find me something to transport her with. Gurney, antigrav cargo pallet, I don’t care. Just get it done. 

Tito: response

Arys nodded once more, the added time-pressure making her work faster and having to opt for a quick-fix more than once. This would need a decent follow-up, but better followed-up than dead. 

Tito:  response

Trovek: Doctor, can you counteract that with medication? 

Ayala:  response

Trovek: Almost done. Two more minutes and then we *have* to get moving or we won’t make it to sickbay on time. 

Tito: response

Ayala: response

TAG/TBC

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Lt. J.G. Trovek Arys 
Medical Officer 
Starbase 118 Ops
J239809TA4