injured person to care or notice. Besides, the nurse in me won’t let me go on.
I pull up past the pedestrian, park near the curb, and get out of the car.
A couple of other cars have stopped and two young men get out of one of them and hurry over to the victim. One of them, I’m relieved to see, is already on a cell phone, presumably calling 911. I hurriedly join them and do a quick assessment of the victim on the sidewalk.
That’s when my heart nearly stops. I recognize the coat first, then the face.
It’s Trina.
Chapter 42
I’m pretty certain that Trina getting hit was no accident and every nerve in my body is screaming at me to turn tail and run. But I can’t leave Trina lying here on the sidewalk like this, so I shift into nurse mode and do a quick triage. I’m instantly drawn to her left leg, which is bent midthigh at an impossible angle. Her femur is broken and one jagged end of it has ruptured through her skin and her pants, leaving a large, gaping wound. It’s hard not to gawk at the injury but I don’t see any major bleeding so I remember my nurse’s training and focus on my ABCs instead.
Trina is unresponsive but breathing, though her breaths have a ragged gagging sound to them. I kneel down at the top of her head, place my hands below her jaw on either side, and push it up to better open her airway. Almost instantly her breathing quiets and improves.
“Are you a doctor or something?” the guy talking on the phone asks me.
“I’m a nurse.” I hear him relay this fact to the 911 operator. I look over at the second guy and say, “Can you take over here and hold her jaw like I am to keep her airway open?” The guy looks scared out of his mind but he kneels down beside me and lets me instruct him on what to do.
“Be careful that you don’t move her head too much,” I tell him as he positions his hands where mine were and thrusts Trina’s jaw open. “She might have a neck injury.” Next I feel along Trina’s neck for her carotid pulse. It’s there, but it’s very fast and thready. Clearly she is in shock and I’m relieved to hear the distant approach of sirens.
“Oh, shit,” the guy on the phone says. “Look at her leg. That can’t be good.” I assume he’s talking about the gaping wound until he says, “Is it supposed to be pumping like that?”
Quickly I look down at the leg. Sure enough, a small geyser of bright red blood is now rhythmically squirting out of the wound. Often times when an artery is ripped traumatically it will spasm for a period of time and clamp down on itself—a potentially lifesaving reaction that can temporarily contain bleeding. But as shock sets in the vessel eventually goes flaccid, triggering a hemorrhage. I suspect that is what has happened here and the fact that it might be the femoral artery that’s bleeding makes this a very deadly injury. Trina could bleed out in minutes.
Frantic, I move closer and rip her pants open to get a better look. The wound in her thigh is about three inches across and four inches long. I try to peer inside it but I can’t see very well by the dim light of the streetlamps. After hesitating for a second or two, aware that I am ungloved and about to come into contact with someone’s blood, I press my hand down on the wound to try and dampen the bleeding. But I might as well be the little Dutch boy with his finger in the dike because the blood just keeps coming.
Fortunately a cop car pulls up and two officers get out and hurry over to us. “What happened?” one of them asks.
“Somebody hit her with their car,” I tell him. “I’m a nurse and she’s bleeding very badly from her leg here. How long before an ambulance gets here?”
“Five minutes or so,” the cop says.
“She’ll be dead by then if I can’t stop this bleeding,” I tell him. “Do you have a flashlight?”
The cop nods, pulls a flashlight from his belt, and hands it to me. I lift my hand and blood gushes forth in a frightening flow. I shine the light into the wound and what I see makes my heart skip a beat. Based on the size of the vessel I see pumping out blood, it is indeed Trina’s femoral artery that has been severed.
I plunge my free hand into the wound, making the people around me gasp. I feel around for the pumping ends of the artery and when I find it, I pinch my thumb and two fingers around it as tightly as I can. Trina’s blood is warm and slick on my fingers and I have a hard time maintaining my hold. But at least the blood has stopped pumping. I look at the feet of the people standing around me and see that the guy who was on his cell phone is wearing sneakers. “Quick,” I say to him. “Give me one of your shoelaces.”
The guy looks momentarily puzzled, but he squats down and starts undoing the lace from his left shoe. Moments later he hands it to me and it’s none too soon; the fingers I have clamped around the artery are starting to cramp like crazy.
“I can’t let go,” I say. “If I do, she’ll bleed to death. Someone needs to help me.”
“Tell me what to do,” one of the cops says.
“Put on some gloves,” I tell him.
He dashes back to his car and returns a moment later with gloves on. “Now what?” he asks.
“Loop the lace around my thumb and fingers here,” I say, showing him where. “Then cross the ends over like you’re tying the first step in a knot.”
He does so, his hands shaking.
“Okay, now leave the loop a bit loose and slide it down over my fingers as far as you can. We’re going to try to tie off the end of this artery the way you tie off a ribbon on a gift when someone has their finger on it. Understand?”
He nods and carefully slides the lace down my fingers, moving from one side to the other. My fingers are cramping so bad I can barely stand it and I want to tell him to hurry, but I don’t because I’m afraid it will make him more nervous. When he gets the lace down just below the level of Trina’s skin, or where her skin would be if her leg wasn’t gaping open, I tell him to shove the lace down inside the wound along my fingers as far as he can. He grimaces but does what I ask, pushing the lace down my fingers a millimeter at a time, until I feel one side of it slide off my fingertip and onto the artery.
“That side’s good,” I tell him. “Now do the other one.” He tries to push the lace in along my thumb—a much tighter fit than the finger side—but it keeps sticking to his gloved fingers whenever he tries to pull his hand away.
The ambulance finally arrives and the paramedics grab their gear, rush over to where we are, and stand there a second staring at us. Judging from the expressions on their faces, they are clearly puzzled. But to my great relief I see that one of them has a pair of scissors and a hemostat hanging from loops in his belt.
“Severed femoral artery,” I tell them. Then I focus on the guy with the tools. “Give me your hemostat.”
The paramedic hands me the hemostat and I take it in my free hand. “Get some large bore IVs going and check her pulse and airway again,” I tell them. The paramedics go to work and I turn my attention back to my police assistant. “You can take the lace off.”
The police officer does so and as soon as the lace is out of the way, I open the hemostat and shove it into the wound alongside my fingers. Summoning all of my OR skills, I feel blindly for the open tips of the hemostat until I have them in place around the vessel and just above my fingertips. Then I clamp the device closed.
I wait a few seconds, trying to see if I still feel the faint pulsing sensation in my thumb and fingers. I don’t, and warily I let go of the vessel and remove my hand. The bleeding has stopped.
“I got it,” I say, breathing a sigh of relief and several people in the crowd around me applaud. I realize the number of gawkers has grown considerably and then I see that one of them has a large TV-type camera propped on his shoulder. And it’s aimed right at me.
“Nice work,” one of the paramedics says. “You may have just saved her life.”
“I hope so,” I say. “But you need to get her to the nearest hospital right away or she’s going to lose that leg. Be careful you don’t jostle that hemostat when you move her.”
The paramedics have made quick work of establishing IV lines and stabilizing Trina’s neck with a cervical collar and they are almost ready to load her into the ambulance. I stand up and turn my back to the guy with the camera, looking around for something to use to clean the blood off my hands. An officer sees my dilemma and steers me over to his car, where he hands me a container of antiseptic wipes from his trunk.
