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faofinn · 11 months

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Day 29 - Head Injury

A follow on from a Whumptober fic - here

@mediwhumpmay

Fao’s head spun as they settled him inside. At least it was warmer, though he was still cold. He gripped Sheila’s hand tightly as they fussed, though he could feel himself slipping. He didn’t want to pass out, but it was beginning to feel inevitable, his vision blurring into black.

Fao drifted in and out of consciousness throughout the trip to hospital, struggling to stay with it, despite the people talking to him. When he was aware, he fought against the people touching him but he didn’t have much energy to do anything. Everything hurt, he felt so weak, and every jolt made the dizziness worse. They weren’t far from the hospital, though, and Fao fought to stay awake as they got him inside and transferred across onto their bed, groaning as they moved him.

This is Fao, he's 23 years old. He was playing rugby when he was tackled at his shoulders around half an hour/forty minutes ago. Took a significant hit to the head and was knocked unconscious on impact, though came to quickly, initially GCS 12 rising to GCS 14. Obviously deformed collarbone so query fracture there. No c-spine tenderness, but boarded for MOI. He's been agitated with us, but lost consciousness again during transport, GCS 3 for about four minutes. Became unable to maintain his own airway and had a respiratory arrest. We ventilated him for about 2 minutes before a spontaneous return, tolerated OP and NP during. He's had a gram of IV paracetamol - has a 20 in left ACF. Obs are as follows - Resp at 18, Heart rate 134, sats 97% on air, now 100% on 15L. Bp 103/62, did drop to 89/45 during his unresponsive episode. BM was 5.1, GCS as before, pupils equal but sluggish. He is allergic to morphine, but other opiate derivatives are okay. Do you need anything else from us?”

The consultant shook her head. “That’s great, thank you.” She said, then moved to speak to Fao. “Hi Fao, I’m Grace, I’m one of the doctors here. Looks like you’ve taken a bit of a hit. There’s going to be loads of people around you for a minute, whilst we get you all set up and make sure we know all of what’s going on, alright? It can be disorienting, try not to worry. We’ll tell you what we’re doing as we do it.”

Fao struggled to listen, but just about managed, trying to focus on the doctor’s face. “‘Kay.” He mumbled. “My mum?”

"She's around, just letting us do our checks first."

“Can I have her? Please?” He whimpered.

Sheila pushed through, her son's request breaking through her want to follow the rules. She gripped his hand, squeezing in to press a kiss to his forehead, trying to avoid the blocks and tape.

"I'm here, sweetheart. I'm right here."

He managed a smile. “Mum.”

"I'm not going anywhere, okay? I'm staying with you, I'm just gonna let them do their things they need to."

“Headache.” He complained.

"I'm not surprised."

“Feel shit.”

"Again, not surprised. Was a shitty tackle."

“Don’t remember.”

"Illegal, they knocked you clean out."

“Oh.”

"Yeah, that's why they're a bit busy around you."

“Feel… fuzzy.”

She swallowed thickly. It was just the concussion, that was all. "You will, you're gonna be fine."

“Yeah. Gonna be fine.”

"Course you are."

“Got you, but don’t feel well.”

"These lovely people are gonna fix you up."

“Mm.” He was quiet for a moment, part of him trying to understand what they were saying. He wanted to know what was going on. His brows pulled together as he focused, but didn’t manage to get anything useful to register in his brain.

Sheila recognised the look in his eyes. "Hey. They're wanting to take you for a scan, see if any damage is there."

“No thanks.”

"You don't have a choice." She said gently.

“I don’t want it, though.”

"You need it. You might have hurt yourself more than we can see." Sheila murmured softly.

“No thank you.”

"Fao, you've got to. You currently can't make that decision."

He whined, and although he protested endlessly, he didn’t have a choice. They took him through to the scanner, and he wasn’t sure if he was tired or they’d given him something, but it was harder to focus and stay awake. About halfway through the scan, he’d drifted a little, but almost jolted awake in fear, nausea suddenly overwhelming him.

“‘M gonna be sick.” He said, panic rising.

"We're nearly done, Fao. Take some slow deep breaths." The tech said.

"If he's said he's going to be sick, he's going to be sick." Sheila snapped. "He's not stupid."

“Gonna be sick.” Fao repeated, swallowing thickly. “Help?”

They finally listened to him, and staff came in, helping him onto his side as he was sick. He felt so horribly out of control, held up and in pain, trying desperately to breathe through the nausea. Everything was hazy and horrible, the room spinning, and once he’d finally finished they settled him back on his back. They’d need to do the scan again now, but at least they’d given him some antiemetics.

They’d started to help and he was able to drift again whilst the scan happened, letting the hazy darkness pull him under. They got through the whole thing without any drama this time, and then he was moved back to resus to await the results.

They let him and Sheila know quite quickly that they couldn’t see any significant head injury like a bleed or fracture, that it was likely nothing more than a severe concussion, but they’d need to wait for the more detailed scan report. They could, however, get him out of the blocks and sat up a little, which helped him to feel more awake and oriented. He still struggled to keep his eyes open, and his collarbone was absolutely killer, the painkillers hadn’t really touched it. But at least he was okay.

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faofinn · 2 years

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26. Tickle In The Throat

@sicktember

Fao had been a state when they’d found him. He’d crashed his bike on the way back from a job, losing control and spinning off of the road.

Luckily, the ambulance crew who attended the scene recognised him (and weren’t phased by the gun on him) and took him straight home to Fred’s. They’d been focused on expanding their network in the last year or so, now they had Harrison back in England and their newly renovated basement treatment space. They had more scope to treat more serious injuries, negating the need for potential issues in public hospitals.

Finn and Steve had worked hard to stabilise him, though he was in a bad way. A break to his right femur, broken ribs, a broken collarbone, dislocated shoulder and some significant abdominal bleeding. They’d intubated him when he’d arrived, as he’d started to decompensate. Neither of them had wanted to, but it was for the best.

His internal injuries were significant, but they decided to simply transfuse and see if they were able to get away with non surgical management. Nobody wanted to get out of their depth with a abdominal surgery if they didn’t have to. Not when their only true gensurg was the one on the table.

Neither felt confident with the femur, too, though they managed to reduce it decently with traction. They needed an ortho for that, and that meant waiting.

One of Fao’s colleagues and friends (and a hook up, between Harrison and Ely) was doing more and more work for them, and agreed to come down quickly and sort it, provided he was deemed stable enough.

Once she’d gotten over the shock, Ely had quickly stepped up to treat. She hated being useless more than she hated treating her boyfriend, and at least it kept her busy (and gave her an excuse to stay with him). She was happy enough with how stable he was, and Ollie was given the go ahead to operate. That went well, all things considered, and his abdominal bleeding thankfully resolved itself with TXA and additional blood products.

They decided it was in his best interests to keep him sedated and ventilated whilst his body recovered, and review him in a day or so with a view to reducing the sedation and eventually extubation.

Ely looked after him closely, as did everyone, but Sheila too. With Fred’s business so important, she’d let her own skills fall by the wayside, focusing on supporting her husband and running her own parts of the business itself. But as their own clinical network grew, she realised she wanted to be more useful to the boys. So she took a return to nursing course, and began to find her own skills again. She’d been dedicated to looking after Fao whilst he was out, in their own little critical care bay.

He’d done well over the past day or so, and they’d decided his sedation could be reduced and they could look at extubating. They took it slowly, of course, Harrison in charge with Steve at work and Ely too emotionally overwhelmed to treat properly. Sheila was at his side, as she’d been for most of it. She hated to leave him, focused on making sure he was comfortable and properly looked after.

Fao started to become aware of something after a while, but the drugs were too thick to fight through. Eventually it got easier and easier, and he was aware of pain, and the tube in his throat. Then he realised he couldn’t breathe, he had no control over it. His eyes blinked open and he reached up, clumsy and uncoordinated, trying to get at the tube.

Sheila stroked through Fao's hair as they reduced the sedation, though that wasn't anything new. She hadn't left the basement since he'd been hurt, sleeping downstairs and praying he'd be okay.

When he started to stir, growing more agitated, she kept murmuring to him, telling him to just relax, promising him he was okay.

"Hey, hey. No, leave that." She was quick to hold his hands down, lacing her fingers through his. "It's okay, Fao. Just relax, you can breathe with it. You can, I promise."

Weakly he fought against her, frowning. His eyes flicked around the room, struggling to focus. The panic rose as he couldn’t free his hands, and he twisted to try and get away.

"Hey. Fao, please. Just listen, okay? Focus on me. You're okay. Just relax." She said softly, cursing Harrison quietly. Of course Fao would come to while he was at the toilet.

He whined, the way he moved just causing a flare of pain. Sheila’s voice finally got through to him, though, and he settled a little. It was still hard to breathe, his teeth catching against the tube.

"Careful, careful, sweetheart. You're just fine, I promise. We're looking after you. Hars is gonna be just a second."

He retched against the tube a little, fighting it. He wanted it gone, he couldn’t just relax, despite what Sheila was telling him. Everything felt wrong, his body crying out.

"I know, it’s awful. You're doing amazing. Just relax." She turned as Harrison appeared. "About time."

"Ah, shit. He’s awake?" Harrison hurried over, grabbing some gloves and quickly putting them on. "Fao? Hey, Wolfie. Back with us?"

Fao was convinced he was dying. Everything hurt, burned, and he struggled to get his hand free from Sheila’s, trying again to dislodge the tube. He heard Harrison’s voice, but it didn’t register with him, too panicked.

"You ready to extubate?" He asked Sheila, swapping his hands for hers.

"Let me grab gloves." She murmured, quickly turning away. "Right. Let's get it out, he's just getting himself worked up."

"Fao? Fao. Can you look at me? Come on, you can do it, just relax. Can you squeeze my hands?"

Fao’s gaze settled on Harrison, blurred and unfocused. He struggled, but managed, and somehow through the haze of the drugs he realised who it was. Hars. He wouldn’t hurt him, right? He gripped his hands tightly, fear in his eyes.

"That's perfect, Wolfie. You're doing so well. I need you to listen, okay? When I say, you need to try and blow your air out, okay?"

It took him a little while to process, but eventually he managed to nod, his body slow and unresponsive.

Harrison glanced over to Sheila, happy she was set up too. He nodded to himself, told Fao to take a deep breath out, and extubated him.

Fao just about managed to breathe out, retching as Harrison pulled the tube. He rubbed at his face, frowning and coughing, trying to adjust to breathing without it.

Sheila slipped the mask over his face, apologising as she did so. She stroked his cheek, relieved he was slightly more with it.

His chest heaved, pain pulling at his attention now. He frowned, but leaned into Sheila’s touch.

"There you go, sweetheart. You've done so well."

"Fao? How are you feeling?" Harrison spoke up, sitting on the edge of the bed.

Fao cleared his throat, struggling. “Pain?” He rasped.

"You're in pain? Where? Chest?"

He nodded. His chest, but everywhere, too. He couldn’t place it, overwhelmed.

"That's okay. Sheila? Thanks. Do you know where you are?" He asked softly as she grabbed meds.

He looked around. It looked like any old hospital sideroom, but if Harrison and Sheila were there, maybe he was at home. “‘ome?” He asked after a long while.

"Yeah, you're in the basement." Harrison said gently. "Can you remember what happened?"

Something must have happened, that’s why it hurt so much, but Fao didn’t remember anything. He shook his head, frowning.

"Alright, that's okay. Can you squeeze my hands for me? Both of them?"

Fao did as he was told, squeezing Harrison’s hands in his own.

"Thank you. You're doing amazing. Can you feel me touching here?" He continued his assessment, trying to gauge any deficits.

Fao did the best he could, following Harrison’s instructions and answering his questions. Despite the pain, it was proving difficult to stay awake, his eyes drifting shut without meaning to. With the arm that hurt less, he rubbed at his face, groaning.

"I'll stop being an arse in a second, promise. I just want to check what damage you've done."

"I've got meds. Sorry it took so long." Sheila murmured. "You look exhausted, Fao."

He nodded. “Am.”

"You've been napping for ages Fao, you shouldn't be tired." Harrison teased.

Fao grumbled, but watched Sheila with a tired kind of curiosity as she gave his meds. He was so tired, why wouldn’t Harrison leave him alone to sleep? He’d answer his questions later.

With Sheila finished with meditation, Harrison gave up. Fao needed his rest, and he was happy enough there were no neurological or physical deficits they hadn't already known about. He leaned forward to press a kiss to Fao's forehead, running a hand through his hair.

"Get some rest, Wolfie."

Fao made a happy noise. The meds had already started to work, making him even more tired. The pain was harder to focus on now, and he soon fell asleep.

Sheila refused to leave again, playing with his hair, stroking his cheek. She was glad he'd settled, and that the tube was removed. It wasn't nice to see, not in the slightest, but she knew it was for the best.

"Can I get you anything?" Harrison asked, making sure everything was written down.

"No thanks. I'll wait until he's awake again."

"I'd never have guessed." He rested a hand on her shoulder. "Just remember, you need to take care of yourself too."

Fao slept for a long while, stable and his monitors happy enough. The meds certainly helped to keep him comfortable, though he eventually woke again. Coughing, he struggled to clear his throat, which was raw and scratchy. That made him whine, his lips chapped and dry, too.

Sheila jumped as he woke coughing, immediately in overdrive. She squeezed his hand encouragingly, the other stroking his cheek.

"Fao? What's wrong?"

He cleared his throat again, frowning. “Sore throat.”

"Oh, sweetheart. Of course it is. Let me get you some water."

He couldn’t get rid of the stupid tickle in his throat. “Throat sweet?” He asked, his voice rough.

"Just water for now." She said softly, passing him the cup. She didn't let go, though, holding on to guide his hands as he drank. "Little sips."

He took the cup in shaky hands, wincing in pain. He appreciated Sheila’s help, sipping the water slowly. It helped to soothe a little, but didn’t fix it. “Why no sweet?” He asked, fumbling a little over the words. It was hard, trying to use his brain.

"I want you more awake first." She told him. "The last thing we need is you to choke after all our hard work."

He frowned. “Wouldn’t choke.”

"When you're more awake."

“Hurts.”

"Your throat?"

He nodded, sipping his water again. “Yeah. Fix it?”

"I wish I could fix everything, sweetheart. Hopefully your sips will help, yeah?"

His memory was hazy, and he coughed again, turning his head away as he tried to clear his throat. “Why does it hurt? Why so scratchy?”

"You came off your bike, sweetheart. Had an accident. You got brought back here, Finn…Finn had to intubate you. You had some internal bleeding, but that's settled down, and you've broken your femur. Ollie's been in and fixed it up for you."

He frowned, clearing his throat. If he’d been tubed, that definitely explained his throat, and coming off his bike explained the pain. He vaguely remembered Harrison that morning, and panic. Had they just pulled the tube? Maybe. That explained a lot. “Oh.”

"You're recovering now, that's the main thing. You just need to rest and we'll do all we can for you." She told him, patting his hand.

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