side - sim: A Desperate Consultation

Posted March 27, 2023, 11:30 a.m. by Lieutenant Commander Dr. Solomon Kane (Chief Science Officer/Research & Development) (James Sinclair)

Posted by Lieutenant Commander Alexis Bonner (Assistant Chief Medical Officer) in side - sim: A Desperate Consultation

Posted by Lieutenant Commander Alexis Bonner (Assistant Chief Medical Officer) in side - sim: A Desperate Consultation

Posted by Lieutenant Commander Alexis Bonner (Assistant Chief Medical Officer) in side - sim: A Desperate Consultation (Tag Walker)
Posted by… suppressed (11) by the Post Ghost! 👻

Brad shrugged. “I’m sold, as long as you have the mother’s consent before you actually perform any surgery to implant it,” he said.

Cmdr. Dr. Brad Walker
Chief of Staff

Kane looked at Walker and said “You’d probably have ta be there too. I can’t see this being done with only one surgeon. One to implant the device… one to maintain the mother. It’s gonna be super-tricky. Lots of variables we can’t account for in here.”

Kane, CSO / R&D

“And you.” Alexis’ gaze dropped from the image and met his, “Incase adjustments need to be made to the device as we work.”

“Anything else we should be aware of before I talk to Daamu?” Alexis hadn’t told her about this not wanting to get her hopes up. If they could successfully place the device their chances would increase significantly. But another surgery was risky. Daamu had a difficult decision to make and Alexis wanted to be able to answer her questions as best as she could.

Bonner, AMO

Kane shook his head and said “Nope. That’s all of it.” He looked at Walker and said “Its risky. But even with the risk, they’re chances are better than right now.”

Kane, CSO / R&D

Daamu readily agreed to the surgery. Her husband wasn’t quite so ready to agree. He was concerned at the risk of another surgery. Their questions were asked and answered. Alexis poured over the design of the fetal life support device, it’s placement design as well as the port.
She started the lab on synthesizing amniotic fluid for the artificial womb as well. Alexis took scans and vitals, studied them against the device until she could recite the proceedure in her sleep.

The time to think and decide was taken that night as Daamu’s vitals began to drop again, her heart and cardiac system working too hard to provide for both her and her baby. The baby’s heart continued to work, but began to falter. Blood flow scans showed not enough oxygen or blood was flowing into the baby either. Daamu and the fetus wouldn’t make it without the surgery. Cirjar had to make the decision.

Alexis was paged Walker and Kane to the surgical suite. The devices had already been brought to sickbay. The tiny life support device sat on a table beside the surgical frame and then artifical womb across the room, so far empty. Jt’nal and Xavier prepped and brought Daamu to the room activating the surgical frame and cardiac support untis. Alexis went into the surgical scrubber room, donning her red scrubs before entering.

Bonner, AMO

Brad followed shortly thereafter, also scrubbed up and with an unusually serious look on his face.

“I think it’s best if you handle the delicate parts of this, Dr. Bonner,” he said. “I’ll monitor Lt. Daamu and provide any supplemental care she may need while you care for the baby.”

It had been several years since he’d actually performed a procedure more complicated than an intake physical.

Cmdr. Dr. Brad Walker
Chief of Staff

Bonner nodded, “Yes, sir,” and moved over next to the bed, checking that everything was in the order she needed and preferred.

Kane arrived and scrubbed in. He was unusually excited. It had been a long time since he had been allowed to see a patient, let alone perform surgery. His normally unkept hair and tattoos were nowhere to be seen under the red surgical scrubs. He walked in and looked at the monitors. “He shouldn’t have waited so long to decide. Risk has increased about seventy percent. Neither mother nor fetus is stable enough for this. But I don’t think they are gonna get any better. Let’s get this done.” He looked at the lab tech NE H’len across the room and said “Bring the amniotic fluid up nine degrees in temp, and keep it matched to mother’s temperature. Increase O2 levels inside three percent and set the heart-beat simulator to Denobulian norm. And I need some music. Ear piece if Bonner and Walker don’t want to hear it. Earth. Late twentieth century. Band name ‘The Clash’. Start with song ‘London Calling’.” And he looked at Walker and Bonner. “Ok Lex… its your show. You got ths.”

Kane, CSO / R&D

Bonner nodded absently. She was zoned out, well zoned in actually, focused totally on Daamu and the proceedure. “Stats?”

Xavier read them out to Walker, “Cardiac support at 70%, HB 110, respiration rapid and shallow, respiratory support oxygen mix at 60%, Blood oxygen at 91% and fluctuating.”

Brad frowned. 91 percent was technically acceptable, but quite low for someone with ostensibly no other medical condition other than pregnancy. He also didn’t like the “fluctuating” part, so he reached down and bumped the O2 mix up to 70%.

Jt’nal read off the fetal stats, “Heart rate 120, fetal movement 6, blood oxygen 87%.”

Alexis slid the surgical frame into place, “Xavier, activate the Alph wave and Somnetic inducers.” She watched the readings until Daamu was relaxed and deeply asleep. “Activating drechtal beams into the dural sac.” Her hands tapped away at the screen and then slid smoothly along the interface. “Jt’nal prep amniotic fluid transfer.” Alexis picked up the laser scalpel choosing to continue manually, “Beginning horizontal incision of maternal abdominal wall.”

It was a careful process, cutting through each layer making sure the laser cauterized the incision to prevent blood loss. Alexis glanced at the fetal images, “Beginning uterine incision.”

OOC: Please take it and run with it.

Bonner, AMO

Brad gave a side-long glance to Kane, though the other man seemed to be in his own world as well. Just as well, he wasn’t entirely a fan of 20th century “prog rock”.

He returned his attention to the monitor, checking to see how Daamu’s body was handling the surgery.

Cmdr. Dr. Brad Walker
Chief of Staff

Kane watched Bonner make the incisions and then began to look at the fetus. The device was sized correctly and all the diagnostic systems were showing green. With the sound of Joe Strummer’s voice in his ear, he looked across at the artifical womb and said NE H’len. “Status?” he asked and was given a silent nod in response.Kane nodded back and turned back to where Alexis was working.

Kane, CSO / R&D

Alexis made the final cut allowing her to open the uterine wall. The baby was a slightly blue in color. Not enough oxygen. A scan showed no blockages from the cord to the baby or in the vessels leading from placenta to mother. Just very low oxygen content in the blood and sluggish movement. “Jt’nal start fluid transfer,” Alexis ordered as the amniotic fluid began to flow out. There was no helping that, but the volume had to stay high enough. She needed more focused detailed fetal readings so they could supplimenta support. Alexis reached in, gently supporting the fragile bone structure and rotated the fetus. Alexis picked up the tiny spider like device. “Attaching central sensor node above the Umbilicus. Confirm active readings?” Alexis asked Kane without looking up.

Kane looked and said “All systems active and functioning. Clear for attachment.”

Daamu’s blood pressure began to fall. “Blood pressure falling. Was 110/80 now 101/70. Pulse increase to 142,” Xavier reported. “Respiration rapidity.” Scans would show the beginning of fluid in Daamu’s lungs. The beginning of pulmonary edema. “BP continuing to fall 98/71.”

Kane moved to the head of the table and said “Get me a ten gauge chest tube and a scalpel.”

Carefully, she couldn’t rush and place the nodes wrong. “Confirm nodes 1, 3, 2, and 4.”

Bonner, AMO

The technician watched the display and said “All nodes confirmed.”

Jt’nal took scans of the fetus from the surgical frame and tricorder and compared with the technician. “Readings confirmed. Fetal heart beat 101, fetal O2 91%, fetal gross body movements 0, fetal muscle tone 0, fetal breathing 1 10second duration, amniotic volume replaced at one ml per second.”

Kane took the laser scalpel and cut a one inch verticle incision in the left side of the mother, between two ribs. He took the forward end only the tube and, without any timidity or even hesitation, pushed the tube into the incision hard. There was an audible POP as the tube breached the lining around her lungs and was forced into the lower lobe of her left lung. Soon, a gray-yellow fluid began draining out. Kane looked up and stared at the vitals reading on the display… and the respiration began to improve after a few moments. “Get me surgical sutures.” He wa shaded the curved needle and thread, and he sewed a knot above and below the tube, closing the flesh around it and anchoring it in place.

Kane, CSO/R&D

Alexis carefully removed her hands from around the fetus and then picked up the port tube and auto suture. “Placing port tube and beginning closure of uterine wall. Increase amniotic fluid transfer to 2 mls. I need oxygenated blood ready to go through the port.”

Xavier continued to call out Daamu’s vitals. “Respiration holding at 10 breaths per minute, BP continuing to drop 92/68. Pulse holding at 142.” Daamu’s heart was loosing to the strain.

“Fetal heart rate spiked to 118.”

That was a better pulse, Alexis looked up at the readings. The O2 readings were still low…the baby was going into distress. Alexis looked back down and paused. “There is blood in the amniotic fluid. She’s hemorrhaging.” Alexis stopped suturing. “I need that blood.” Jt’nal brought the unit and connected it to the external port. “Release the port connection control to manual,” Alexis said to Kane or his technician, whoever could do it. The baby had to be connected to the machine before Daamu’s body stopped providing blood circulation.

Bonner, AMO

Kane almost pushed a nurse out of the way. “Port connections released. Get me combined twenty-five mils of Compradezene and ten of adrenaline.” The same nurse he shoved grabbed a hypo and dialed in the meds and handed it to Kane. He grabbed it and set it against Daamu’s neck and there was the tell-tale pop and hiss. Kane looked at the monitor. After a few seconds, he said “Mother’s BP 107 over 60. Heart rate 154. Keep an eye on pulse. If it goes over 200, she’s going to crash.”

Kane, CSO / R&D

There was no room for blaming Cirjar for waiting or second guessing what she should have done or could have done. The fetus had all the signs of placental insufficiency, slow movement, low growth, lack of oxygen on scans, but the placenta was fully formed and there were no blockages. Alexis had checked many times and when she’d done the cardiac procedure she’d checked to make sure the placenta hadn’t become detached. Why was there bleeding now? These ran through her head as she pulled the released port tubing and attached it to the central sensor connection creating another umbilical cord. Alexis reached over to the infusion unit, “Setting drip to 40 mls per day.” It was a slow drip, but she didn’t want to damage the fragile system by flooding it too fast and the baby was still small. Alexis watched as the blood began to drip slowly through the tube.

Alexis went looking for the source of the blood. Had she nicked something, or the laser scalpel not cauterized something correctly? No, there was not evidence of that. Had she torn something on the fetus? No the blood was no where near the baby. Then she found it, behind the placenta. The artery leading into the placenta looked blown, like a poorly placed IV had blown a vein.

“Fetal heart rate 130,” Jt’nal called as more blood was lost from the tear and a moment later in response, “Heart rate 168,” Xavier read out. Then more blood began to pump out of the tear as Daamu worked harder to provide what she could not and the baby began to go further into distress. It was a vicious cycle that they got to watch as mom and baby were killing each other. “Microsuture.” Jt’nal placed it into her hand and began to work at closing the tear. What was she missing? These were just bandaids, it wasn’t going to make it better long term. Her eyes flicked to the infusion unit on the port and back. “Give me a blood volume scan.” The blood should be bright red and thick, this was red but thin. She didn’t glance up, “Blood volume.” Did she really need to explain this. Healthy Denobulan women carried 5 litres of blood. This far into pregnancy Daamu should have around 7 by now to compensate for the baby and placenta. Was it that simple? How did she miss that? D@mn! The blood from the port should have reached the fetus by now but it would be minutes before they saw a solid difference.

Bonner, AMO



Kane moved swiftly to the infusion pump and wrenched the side of it off. He pulled off his right glove and began gritting his teeth as he manipulated and twisted the actual mechanical and electrical components. At one point he grabbed a pair of surgical clamps with is still-gloved hand and shoved it into the machine using them as pliers. A moment later, the infusion pump sounded like it was a small jet engine, and smoke began to rise from the machine. The readout began show that the pump was forcing blood through the port at a rate that was so high the readouts just showed a flat line. “Is the artery closed? If so, prep for transport to the artificial womb.” and he began dialing in the necessary data. “This is going to send her into shock. Prep fluids and get ready to invert the table.”

Kane, CSO / R&D

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