I'm writing a little romance story and it begins with the main character finding the girl injured on the side of the road. The town they live in is about two hours away from a city. So he drives them to the local doctor's clinic. What would be the procedure from then on? Would the doctor drive them to the hospital? Would they be examined and deemed okay by them? Or would the doctor call for an ambulance to head out and drive them? I've never had much experience with small town hospitals or clinics--mostly lived in cities so I'm not exactly sure on the venacular or terminology.
Setting is contemporary, in a small town in Washington about two hours drive from the nearest city; most likely Spokane.
She's unconscious. Head trauma, swollen eye too. Small lacerations. She was attacked by somebody and left to die essentially on the side of a road.
You'd probably want to ask in a medical related forum, or hope someone in that field responds here (I know there is at least one nurse on this forum). Based on that info, I doubt a helicopter would be requested. In severe accidents a helicopter is sometimes used but I don't know the kinds of distances they can support round trip. In any event, I don't think your example would justify one. My guess (and it's just a guess) is the doctor would stabilize the patient, and they'd be given a bed until transport could be arranged to a better hospital. I don't know the specifics but I can almost guarantee that the doctor won't be the one driving. I also don't know if the medical transport is an independent business or if it is affiliated with the major hospital or smaller clinics. I also don't know if the medical transportation is one patient at a time or if they have a vehicle that can transport multiple patients at a time, but that's another thing to research.
I could also see the patient being treated, stabilized, and then discharged if and when they can walk out by themselves, and advised to follow up at a larger hospital (maybe a CAT scan, etc.) at their own convenience.
The doctor would do what they could and then call for an ambulance/chopper. Who knows how long it would take, or how busy the vehicles would be, but it would be a straightforward procedure. That's a regular day for all involved, but there could always be complications... weather, Covid, zombie apocalypse, etc.
I wasn't sure but that was the way I was going to go with it anyway. I just wasn't sure but this makes the most sense for my story.
Federal regulations would be an issue with this, since she is unconscious. @Bruce Johnson's post above is the most likely unless the local facility is a Class 1 ER.
They'd stabilize the patient in the ER and call the nearest trauma center for transport. They wouldn't fly unless the patient is unstable. If the trauma center doesn't have a transport team (unlikely), they'd call for an ambulance. It would be unheard of for the doc in the original ER to go on the transport. If the patient is so unstable that EMTs couldn't handle it, they'd call around to find a trauma center that could do it, no matter how far away. If it were more than a 2-ish hour drive one way, they *might* fly. If the Neuro guy at the small hospital thinks he can handle the patient, she'd be run through a MRI and admitted to their ICU, then transferred to the door when she was awake and stable. She'd be discharged from there, usually after several days.
I was in a small hospital in Baudette, near Lake of the Woods in northern Minnesota, next to the Canadian border. We were on a fishing trip. The boat was going full speed when the guide hit a sandbar and the boat stopped dead. I was sitting down, then silence and flying through the air. I don't remember my head hitting the seat on the way by but it did. I do remember smashing into the front wall by the bow, ending up at the bottom of a big man pile. A friend drove me to the medical facility, which was a combined clinic and small hospital. I walked up to the receptionist and said, "I was in a boating accident." I expected with the bruises, cuts, and blood on my face they'd hurry and sit me a wheelchair and cart me off for evalutation. Instead the receptionist seemed a little nonchalant about the whole thing. "Do you want to be admitted through the clinic or the hospital?," said the receptionist. I thought it was a really strange question. I had no idea, I just wanted help. I said to admit me through the hospital. Instead of putting me on a backboard and neck brace until they examined me like I expected, they had me sit in the waiting area. A few minutes later a nurse called my name and I followed her back to a little examining room. They cleaned up my wounds, then sent me for some kind of imaging, don't remember exactly what kind. The scan showed I had an arachnoid hemorrhage, a brain hemorrhage. They sent the scan to a doctor in Brainerd, and said they might airlift me depending on the doctor's recommendation. Brainerd's recommendation was to keep me for observation and do another scan the next day if no problems occurred. Turns out I was lucky, no progressive damage. Other than a headache for about a week and orders to take it easy for six months, I was good to go. As far as the hospital experience, I found it almost charming. It reminded me of watching the Andy Griffith show. The nurse told me my injuries didn't require that I be admitted to the ICU, but since there was only one other person in the hospital, and that person required intensive care, they put me in the room next door. One thing I love is Americana, and I have a sense of appreciation especially for rural Minnesota culture. I'm not native to Minnesota, but have lived here for 40 years. If you've ever seen the movie Fargo, that's exactly what it sounds like when you get a few miles out of town. Many were offended with the movie's portrayal of characters and the Minnesooota accent. I'd say, "So you've never been to Bemidji, have you?" There's a Minnesota thing called "hotdish," which is known most places as "casserole." For supper I had the most delicious hotdish I've ever tasted, along with apple cobbler for desert. I pictured Aunt Bea shuffling over to the hospital with a tray full of delicious food like she used to do for the folks in Andy's jail. I'm sure the doctors and nurses and anyone else who was around had the same dinner. This was not something out of a commercial hospital kitchen. I had my scan in the morning and went on my merry way. Thanks for giving me an excuse to recollect an interesting, if somewhat painful, experience. If you're trying to portray a small town medical facility, or anything else for that matter, consider building a background of rural cultural traits that would be encountered in that location.
The irony is palpable. Though you probably didn't care at the time. Spoiler: Big pic! Baudette.jpg Is this the very hotdish of which you spoke? By any chance?
Yes that is the very hotdish. And the nurse referred to me as "Sweetie." I know that annoys some people, but especially in that strange moment in my life it seemed to fit perfectly. It was one of those times when it feels like you're an actor in a movie and the other characters come in just at the right time.
