Medical Training
Posted on Fri Jul 24th, 2020 @ 1:42am by Lieutenant JG Mattias Constantine & Lieutenant Avira zh'Kenarh M.D. & Ensign Kathryn Bell
Mission:
Mission 3 - 100
Location: Atlantis, Sickbay
Timeline: Day 38, Month 2, 17:15
1719 words - 3.4 OF Standard Post Measure
Bell entered Sickbay and gave the doctor a smile. "Our first patient for training should be on his way. I talked to him earlier in the mess hall, and he seemed eager."
Avira looked up from the PADD she had in her hand, "Ehm," She looked around the sickbay, they had just managed to got everyone back to a place where they could finish their recuperation from their quarters. A moment of silence in between the storms they had to weather out there in the unknown, "Alright, do you have a curriculum prepared or are we just starting with basic first aid?"
"Well, I assume, if he went through STC, he better have first aid down... Not saying we can't refresh him... I've been thinking--most of the injuries we've been seeing are from falls, bumps, bruises, and fractures as a result of weapons fire. So, head trauma, setting bones, burn treatments, that kind of thing... What do you think?"
"Oh, yeah, definitely trauma care," Avira could think of a thing or two for some untrained personnel to get trained up in. Easy bruise and open wound care. She wasn't too sure about setting bones because usually those equalled internal damage as well, "We'll figure something out."
As the medical staff discussed their plan, the double doors leading into sickbay parted and Lieutenant Constantine walked into the room. Dressed in his duty uniform, he tugged his sleeves back down to full length before making his way towards the duo of Doctor zh'Kenarh and Ensign Bell. As he walked, his eyes darted around the room and a relieved expression slowly spread across his features as he realized that all of the patients he had seen as a visitor over the past few days had been released to bed rest.
"Doctor. Ensign," Constantine greeted them with a smile. "It is good to see you both. I hope you understand what I mean when I say that it is a relief to see that your office is empty," he motioned around. "Is it a good time? Kathryn mentioned in the mess a few days ago that there might be an opportunity to start learning beyond the basics that they give us during OCS. Seeing how there isn't much negotiating to be helping with at the moment, I'd like to volunteer."
"Call me Kate, and yes--we were just discussing that... Doctor?" The Ensign gestured for Avi to take the lead, as senior officer.
"Kate, got it," Matt smiled.
"Good... morning," Avira seemed hesitant, she had lost track of time lately with all the extra responsibilities on her, "I hope you're doing well," She didn't really wait for a response on the question, "have you ever learned how to suture a wound?"
"No, I haven't. I've had it done to me once upon a time when I was younger, dumber, and more foolhardy," he pulled his left sleeve up to the elbow, revealing the faint remnants of a scar that had healed long ago. "I remember watching the doctor put the stitches in. He was old fashioned - still gave immunizations with needles if you'll believe it," Lieutenant Constantine walked over and stood next to Avi and Kate.
"Well, time for you to get behind the desk, as it were," Kate replied. "Here,"--she pulled out a synthetic cloth dummy from a cupboard--"this will do for a model."
The dummy would have been familiar to just about everyone who put on the Starfleet uniform. "Bob" was the moniker given to the doll by someone whose name had long been forgotten, and even though they were thousands of light years away from San Francisco, Mattias was instantly transported back to the basic medical training he and all of the other officer candidates had completed. Some had decorated their Bobs in various, colorful ways, but there was no doubt to the effectiveness of the simulations provided by the rudimentary training device.
"Ah, this brings back memories," Matt smiled as he inspected his patient. "Most of them are fond. Shall we inflict a wound upon Monsieur Bob?"
"Quite..." Kate picked up a small laser scalpel *can be corrected if I'm too far ahead*, and inflicted a precise, four centimeter gash in the dummy's shoulder. "This is typical of what you might from a bladed weapon, such as a Klingon bat'Leth," she told the lieutenant.
"The needle and thread approach is actually not a bad way to start learning. Plus we'll probably have more of that laying around than the more advanced suture kits," Avira stepped up to 'Bob' and pulled the wound apart a bit, "in most cases such wounds will be a lot less neat, jagged edges. Keep in mind that you need enough skin to be able to pull it together, otherwise it might tear." She grabbed the needle and thread and put in a tiny knot to prevent it from slipping through. Showing the first stitch, "see what I mean?"
"Makes total sense," Constantine nodded as he took the needle from her and studied the serrated injury suffered by the training device. His hands were steady and his fingers articulate, but the motion of pushing a needle through the doll was new to him. Practice would be required. "I see you tied a knot on the end to keep the stitches from pulling through which makes sense, and it makes sense that you would want enough material, for lack of a better way to put it, on both sides of the wound or else the stitches could just rip out again. Is there a rule of thumb on how far is too far?"
Avira looked at her own them before looking at the stitches he was making, "A thumb would definitively be too far out." She leaned in guided his hand slightly closer to the wound, "The skin is fairly strong, so you can get away with a relatively small bit of... material" She used his own words to describe it, "In general if the two pieces of skin start to overlap due to the stitching you're leaving too much skin," she showed a small bit of overlap between the skin at the start of the stitches.
"What about prior to the stitches? What steps should be made to clean the wound prior to the suture?" Matt asked as he showed his handiwork to the others for inspection. "Infection has to be just as bad as a cut from a bat'Leth, medically speaking."
"Infection is something that should be prevented, if possible. Cleaning with a disinfectant is important." Avira took out a PADD and made some notes for herself, "I'll provide you with some reading on the subject." She finished her note. "You want to make sure the dirt and grime are cleared from the wound, once the blood returns to its natural colour, that's usually clean enough." She took a moment to lock eyes with Mattias, "if you do clean a wound, make sure the skin is dry. Wet skin is brittle."
"I'm glad you said something then, because that almost sounds counter-intuitive at first," Matt stepped away from his patient for a moment, having felt his PADD alert him of Avira's incoming message with a short vibration. He opened the document and scanned through the opening pages before stashing the device away into its usual pocket. "Thank you doctor, I'll be sure and read through the material and take some notes. If I have any questions, would you mind helping me with some answers? What's your preferred method of communication?"
"You can make an appointment if you want some face to face instructions, otherwise you can send me a direct message through the ship's communications centre." Avira took another on her PADD, "You will also find a breakdown of the triage steps. Quick and easy assessment of who you should send where if you come across an injured crewmember."
"Also, if you don't mind, I'll reset our patient here and take him with me," Constantine motioned towards the doll. "I want to practice - I can already tell this motion needs to be second nature before even attempting to apply it in an actual scenario."
Avira nodded, "You're more than welcome to practice. Take what you need. Though keep in mind that if you're practising alone there's a risk that you might be reinforcing bad habits," she put her hands behind her back and looked at the officer, "better to work in pairs, I'm sure Doctor Bell would be happy to help out. Otherwise, make some videos of your work, and we can assess later."
"Point taken. Fingers crossed that there is enough idle time allocated to both of you that we are able to continue our lessons, but honestly ma'am," Constantine turned and addressed Dr. zh'Kenarh directly, "I cannot thank you enough for everything you've done already, and our debt to both of you continues to grow as you continue to make a difference for us moving ahead. I'll get my nose in these textbooks and meet with Doctor Bell for more practice. In the interim, if you need help around here, even with little administrative stuff, I'll do my best to chip in."
"I'm happy to help," responded Bell, cheerfully. "Just mind you follow what we say. I'd hate to have to patch someone up more because of a roughshod job." She quirked her lips in a smile, trying to communicate both the sternness and humor in her statement.
"Thank you Kate, and absolutely agreed on the last bit - 'do no harm,' which is a noble oath to take on irrespective of your field of work," Lieutenant Constantine nodded as he caught Bell's glance, understanding the subtlety of what she was trying to communicate to him. "I'll take a chair and sit and practice in the corner for a while. I'll check in with you before I leave so I can get some feedback, but seriously thank you again."
Avira gave an encouraging nod and stepped away from the two to focus back on some of the administrative work that was still waiting on her. The humans did seem to like their administrative work quite a lot, she wasn't sure if that was something she would get used to.
