"Keep them light until I listen to his chest a little better. We've got|
to rule out traumatic chest
injury." Gage told him.
Mike Stoker was ready with cold water and he stood close by for
word to begin cooling measures by the time the three firemen
carried the boy over to all the medical
gear and Chet's treatment tarp.
"Start with his legs, arms and abdomen only, Stoker. A very light
We don't want to chill him too fast here." said Roy. "If you see him
start to shiver, stop
immediately and get him snuggly wrapped up.
Keep an eye out for any active blood flow into your water.
checked him out very well yet for other injuries past these bruises and
Mike Stoker began his bathing with just an inch wide trickle from
the end of the red hose's nozzle.
"Got it." said the engineer
softly. "Is he resisting Chet's vents yet?" he asked DeSoto.
said Roy with a worried frown. "We'll try to change that with
some I.V. epinephrine real soon. Craig.."
he said, wiggling fingers
for the biophone receiver.
Brice handed it over and then got busy
with Roy's stethoscope on
assessing the flushed red boy's lung sounds.
DeSoto never took his
eyes off the boy while he spoke with Dr.
Early. "Rampart, this is Rescue 5-1."
Joe Early flicked the recording machine off pause and said, "Unit
calling in, please repeat."
##Rampart, this is Squad 51.##
"Go ahead on your pediatric suffocation victim, 51. I've been
##Rampart we have a male approximately four to five years of age.
unresponsive, being ventilated on 100% O2. He's
markedly overheated with blunt force trauma in evidence.
a beating. I'll cover exactly what areas are involved after initial vital signs.
is 150/102, pulse is weak and rapid at 134, breaths unassisted, were
at eight and very irregular.
Our victim is currently undergoing a cold water
washdown over his extremities and abdomen to allow
us to start to get
a handle on a very high body temperature.##
"What is it, 51?"
by, Rampart. We've got to work around some spinal precautions to
Let me know what you find. Has your victim shown any indication of prior
Rampart. No signs of incontinence or unequal pupillary reaction
"Ok, 51. Start
him on an I.V. of..........
Date: Fri, 23 Sep 2005 13:25:04
From: "Jeff Seltun" <firstname.lastname@example.org>
Subject: The Saving Grace of Professionalism..
....Lactated Ringer's at TKO and another of 50% dextrose
in water. Protect his airway
judiciously, 51. There's a strong possibility
of respiratory alkalosis developing from your active
might bring on secondary hypokalemia. Are there any signs of deep
Brice checked, running a blunt scissors point up both the boy's bare
feet. He also
pinched the skin sharply behind both the boy's knees
while holding them bent and upright. Not one
twitch manifested. Craig
shook his head.
DeSoto shared that news. "Negative, Rampart."
##Ok, go ahead and intubate him with an EOA. Sounds like he's already
largely in a coma from his
exposure. What's his core temperature
Johnny took out the thermometer probe from
the child's rectum and
read it under penlight. "41."
"It's at 41°c, doc." Roy told Dr. Early,
biting his lower lip.
##Continue his cooling measures aggressively, 51. Halt all irrigation
his body temperature reaches 39°c and let it drop no lower.
I want an EKG as soon as possible. If
he develops seizure activity,
use a benzodiazepine variant such as Ativan 0.1 mg/kg I.V.
sets in refractory to cooling and initial fluid boluses, initiate
a Dopamine drip and titrate to
maintain a systolic BP greater than 90 mmhg.
Once you've sent me a strip, continue monitoring vitals
and maintain his
full 02 support. Bring him in as soon as possible.##
Roy confirmed his orders.
"10-4, Rampart. Point one mg's Ativan I.V. on
posturing, a dopamine drip to raise any developing
basement BP to 90,
and an EOA. Stand by for his EKG, lead two. I estimate our ETA at twelve
##Standing by, 51.##
Johnny was way ahead of Joe Early. He already had the still child's
dried and patched in and it was only moments before he flicked on
the datascope monitor and linked
it into the biophone.
Roy spoke once more into the phone. "Transmitting EKG, Rampart."
Gage, Brice, DeSoto and Kelly all leaned into the screen to read its tachy
signature. Johnny let
out a worried sigh. "Frequent PAC's and look at this.
Doctor Early called it right on the money.
He's very low on electrolytes."
DeSoto picked up the receiver. "Rampart, we are reading marked
flat T waves with prolonged QTs and prominent U waves on a V tach of
140 with PAC's. There is possible
evidence of Cor pulmonale manifestation."
##I concur, 51. Bolus in 100 cc's of that Lactated Ringer's.
the heat's damaged his lung tissue, causing atelectasis and that backup
into his right
descending pulmonary artery. That's probably why we are
seeing a poor breathing effort and the Cor
pulmonale. It is paramount, 51, if
he crashes, that you avoid using sodium bicarbonate on any defibrillation.
He's low enough on potassium or magnesium as it is.
Use Dobutamine 10 mcg/kg/min IV infusion for
circulatory support with
your first stacking dose of epinephrine should any be needed.##
re-outlined the doctor's treatment and plan if the boy
suffered a cardiac arrest. Then he added,
"Rampart, we've examined
all exposed surface areas on our victim. He's got bruising of the left
of his eye, right lateral ribcage, and on the skin over his right thigh
with no evidence of obvious
fractures except for a midshaft bone break
on his left index finger. Also, we've found that he's
slightly guarding the
lower left hand quadrant of his abdomen."
##Might be splenic involvement.
I'll have a surgeon standing by.##
"10-4, Rampart." Roy practically threw down the biophone into its case|
in his eagerness to get the
boy intubated and moving out.
Gage re-read the thermometer again, taking it from in between the
frogged legs where he lay in his moistened shock sheets and he held up
his hand. "Ok, Stoker,
that's good." he said, and he motioned for the
engineer to take away the cold water stream.
took a small ambu bag from Chet's hand and fastened it to the
end of the boy's esophageal airway once
he was through inserting it.
He gave it a few short squeezes while Craig checked the tube's placement.
"Ok, Chet. Take this over again." he said in a hoarse whisper.
Brice gave a curt nod. "It's positioned
correctly, DeSoto. ...Ready?" he asked
Gage and the others who were bundling up the boy's sheets,
I.V. tubing and
EKG monitor wires away from the pooled water running around his body.
all nods around the circle of quiet firefighters.
The heatstroked young boy's spine board was
lifted and laid straight onto a
half height raised ambulance gurney, and soon, they started
their way to the hospital. Marco quickly followed behind them in the
rescue squad, adding his red
lights and siren to the ambulance's.
The foreman sighed as Cap stepped away from the Cadillac
that he had just double slapped. "I hope he makes it, mister. Cause if he doesn't,
then Marty died for nothing and my losing my job over him will just be
another tragedy this company'll
bear quietly in the private sector..."
Hank just stared at him, and displayed absolutely no sympathy.
"Your poor man didn't have to die at all today! Haven't you gotten that fact in
through that thick
hard hat of yours yet?! This whole rescuing situation was
all ....completely... and utterly.....preventable!"
"I didn't put that car into the gravel pile! That stupid city gang did!" said
the foreman, defensive
and trembling. "Why are you all looking at me like
I was the one who kicked that kid around?"
Scotty, rendered angrily mute, turned his back as he began talking to the
police officer newly arrived
Cap just jerked his head for the other firemen to pick up all the medical
wrappers, labels and needle covers without saying another word.
He headed off to give out a station's
availability ETA to L.A. over the engine
cab's chatter filled radio and soon, they were free of the
sad gravel works
From : crash200225
Sent : Saturday, September 24, 2005 4:35 AM
Subject : [EmergencyTheaterLive]
Marco backed the squad in next to the ambulance just as the boy was
The intense look on both of the paramedics' faces
spoke volumes. The child's condition must have
transport. As he followed the gurney through the emergency room
Marco heard the sound of distant thunder. He turned
back to the squad and rolled up the windows.
There was no way of
knowing how long they would be there.
Not seeing Roy or Johnny in the
hallway, Marco found a seat in the
nearly empty waiting room. Having left his helmet in the squad,
ran his hands through his hair, then over his face.
The rescue had effected him more
than the others knew. His close
friend had died in an 'industrial accident' several months earlier.
Though the circumstances were vastly different, the cause was the same.
and stupidity on the part of the supervisor.
He hadn't told his crewmates about it, not that they
understand. He knew his friends would try to console him, but he
didn't want that.
The rage he still felt drown out the sorrow that
would eventually surface. He just wasn't ready
to face it, not yet.
When he was, he knew they would all be there for him.
Closing his eyes,
an image of the child came to Marco and his barely
controlled anger threatened to overwhelm him.
He thought about who
could do something so horrible to a little child, just a baby
He took a deep breath and let his thoughts drift back to his
Roy said for the third time, "Are you all right?"
He had become lost in his memories and had not
heard Roy calling his
name. "Yes, just tired. How is the boy?"
"Dr. Early stabilized him.
He's on the way to surgery now. Johnny is
getting supplies. He won't be much longer." Roy knew
they were all
shaken by the rescue, but now was not the time to dwell on it. It
was a kind of
unwritten rule not to mention the bad runs for awhile
afterwards. They would talk about it at some
point, but not now.
Five minutes later, the three men were on the way back to the
Johnny seemed to fall asleep before they had left the
ambulance bay, head against the window. Marco
was in the center seat
and asked Roy, "You sure he's not sick or something? He's
"He was okay in the ambulance and at Rampart. Like he said, he's
Nothing some sleep won't fix." Roy answered with more
confidence than he felt. He knew how his
partner could be sometimes.
"What about Brice? He went to check on Johnny and fell asleep
Maybe there is something going around." Marco reminded him.
Roy thought about it for a few moments
before saying, "I guess it
wouldn't hurt to check them both out when we get back."
man saw the smirk on Johnny's face. He hadn't quite gone to
sleep, but before he knew it, Marco
was shaking him. They had
returned to the station and Roy had the passenger door open. He was
taking Johnny's pulse.
"Aw, Roy, Marco, leave me 'lone. Tired is all. Lemme sleep." he
Roy shook his head and sighed. "We just thought you might want to
sleep in your bunk instead
of the squad."
"Huh?" Johnny looked around before stumbling out of the squad and |
straight to the sleeping quarters.
He didn't bother to strip down to
his t-shirt and boxers. He dove onto his bunk and, for the second
time that night, didn't remember his head hitting the pillow.
From : Roxy Dee <email@example.com>
Sent : Saturday, September 24, 2005 8:57 PM
: The Haunted Chat~~
Johnny heard a motion in the darkness in the bunk room
lay. ::That's Cap. Is he restless! And Marco's none
too relaxed either.:: Gage thought as he blinked
away. His roving eyes studied the ceiling and flicked to
the window, which was still
glowing street light blue.
::Dawn's nowhere near yet.::
The dark haired paramedic rolled over
to eye his partner, Roy,
snoring lightly nearby on the next bunk over. Immediately, his
eyes spied an HT on standby lying on the table
between them ::Got you! :: Johnny grinned quietly.
::You finally went for the tired act Brice and I crafted hook line
and sinker if you have a radio
in here with ya.::
Trying not to laugh aloud, he glanced over to Brice's bulk on
kitty corner from him next to Chet. Craig was quiet,
and his glasses were off. ::He must have continued
after I "staggered" in here if Roy was concerned enough
to keep close communication cover
in the bunk room after
checking up on me. Wish I had been awake when he
finally came in for me.
Oh, well. Maybe Chet was
there watching him. I can get the play by play about what
breakfast when it's light out.::
Contented with the progress of his mother hen fostering joke,
Gage flipped back over onto his back and closed his eyes
in a sigh and soon returned to a much needed
later, Captain Stanley flipped back his sheets,
pulled on his suspendered pants, and shuffled into
on his boots. Hank was shocked to find that his face was covered
in a sheen of fine
sweat in the mirror. Slowly, he realized that his
heart was still pounding in his chest. ::Why am
I still mad? We're
well done with it!:: he thought about the dead man at the gravel
nightmare from which he had just awakened was still
playing shadows of strong emotion behind his
A commotion made him quickly turn on a sink flow in a pretend
face wash to hide his damp
It was Marco, just as unsleepy and concealing the fact that he
was actually disturbed.
"Hey, Cap. Can't sleep?" Lopez asked him
as he startled at finding him up.
"Just thirsty I
guess." Cap sighed, hiding the reason why his
sleep had been broken. "I'm headed into the kitchen
for some warm
milk. Uh,... want me to fix ya some? Stoker told me we gotta finish
up that gallon
before it goes bad on us tomorrow afternoon."
Instead of shaking his head, Marco nodded yes. "I
think I need all
the comfort I can get after tonight's run." the hispanic firefighter finally
"Oh?" Cap startled.
He rubbed a tightness in his chest that was coming oddly
boosted heartrate in a pretend scratch through his t-shirt.
"Wanna talk about it?"
him with a haunted look and his eyes flickered over
the hand Cap was using to grip his shirt's front
in an attempt
to silence the hammering under his ribs. That grip, matched his
own, on his own shirt,
that was trying to do the same thing. "Yeah.."
he said softly, meeting his eyes. "I ..think I need
to, Cap... And...
I think you need to, too."
Hank stopped drying his face in a towel with his free hand |
and ended his charade of false calm.
In a rush, whispering
confidentially, Cap let loose. "Oh, it was awful, wasn't it?
I-I- I really
think that I wanted to kill that foreman, Marco. With my
bare hands. And I've never lost my cool
on a rescue like that before.
Not ever. Not even half mentally! So why did I feel something like
that tonight? I still feel plenty angry about it now. And it's two
him by taking Hank's sudden deep admission in stride.
Lopez waved it away with a dismissive hand and
a tiny smile.
He touched Cap's arm, and started leading him to the more private
space offered by
the still warm kitchen and rec room. "Believe me,
I understand completely, Cap. I just lost a good
friend a few weeks
ago due to circumstances alot like those that killed our park gravel
I've been feeling a little trapped myself lately over him."
Captain Stanley's eyes radiated instant
sympathy and caring. "I'm
so sorry, pal. Abou-- about him." he said as they both padded silently past
the quiescent engine and squad in the bay and then through the kitchen's
ok. I....think I'll get over it. Only I haven't figured out how yet."
Marco said, looking shell shocked
and vaguely numb as they both
moved over towards the refrigerator and the stove after squinting
when the autolights came on.
"Think we should call a CISM counselor for a late night session?"
asked frankly, opening up uncharacteristically to his troubled coworker.
"I know it's been
a while since we as a shift, have called for one."
"Nah, having a shrink come to the station would
only wake the others.
And embarrass us further after they nose around a little
for the reason
why. Maybe we could...just have it out just between
the two of us, and see if that'll do any good
before we try anything
drastic enough like calling for one of them." he said, mincing a salt
around pointlessly on the eating table.
Captain Stanley blinked, his back still to Marco, as he
out two empty glasses for their drinks. Hank coughed, trying to
relieve the tightness he still
felt in his jaw. The nausea which always
came with any stress he dealt with began to rise and it finally
him speak as he busied himself with the crumpled milk carton marked
"Use Now." and a sauce
pan over a low gas flame on the stove. So he
finally gushed, wide open.
Cap turned around,
met Marco eye to eye, and opened his mouth.
"Oh, man. I was completely stunned over feeling the way
I did in
front of that foreman. Blind rage, rising grief. A whole gauntlet of
emotions. I- I
didn't actually know what to do with myself after we
found out that our first victim had been killed
because of sheer lame
brained stupidity and total inaction. I've seen people die for
in the past as a captain, but nothing like--" he choked
off, slamming down a lump that threatened
to make his eyes water.
"This was simply the last straw for you, Cap, and very nearly mine."|
Lopez said very quietly. Tears
flowed unabashed down his face
as he drank the heated milk Hank finally handed out to him.
we've got to figure how get it all out somehow, before it
makes us both too hobbled to work well
enough to save those
we can still do something about."
Cap found he couldn't release his grief.
Not yet. Not even
a half an hour later when Marco and he finally returned back to
of their beds and the warm roughness of their beige
Trying to ignore the weight
of stress still bearing down heavily
on his chest, Cap let go of himself into an unrestful sleep.
In the blackness across the room, Craig Brice watched them both,
thoughtfully analytical and soon,
From: "Monster Moofie"
Date: Sat Sep 24, 2005 7:01 pm
Subject: Monday morning breakfast
Meanwhile, back at Rampart the night shift had just
ended. Dixie had called Kel Sunday
night and made arrangements
for him to come meet her and Joe for breakfast. Dix hurried and
out of her uniform and met Joe at the front desk.
Waving to Mike Morton, Joe and Dix headed out
and drove to the
Having enjoyed a peaceful night, Kel waved to them with a smile. He
held up the pot of coffee as they approached. "I secured sustenance
for you two!" he said with a grin.
"How did the night shift go?"
Joe sighed happily as he grabbed the cup of coffee Kel poured
"It was fairly uneventful for once. 51's brought in a kid
who had been found trapped in a gravel quarry.
He was in pretty
rough shape when they brought him in but it looks like he will be
had a few minutes to talk with Johnny Gage while he was gathering
supplies following the rescue. Would
you believe they have added
Craig Brice to 51's A shift?" Dixie queried Kel.
me, Dix!" Kel said in disbelief.
"Nope, she sure isn't, Kel." Joe responded.
to explain further, "The really funny thing is that
apparently the rest of the guys, including Roy,
tried to pull a joke
on Johnny and Craig. Johnny told me he was feeling the change of
just in a sleepy mood so he went to bed early last night
instead of staying up for movies and popcorn.
The rest of the guys
sent Brice in after midnight to check on Johnny. Once he realized
going on, Johnny convinced Brice to set up a joke on the
guys by crawling in Chet's bed and joining
Johnny in slumber.
Unfortunately, they got the call out before it worked."
Kel laughed hearing
the firehouse antics. "Johnny and Brice joining
together to pull a joke?! That is certainly funny!
It was hard
enough when we saw Brice working with DeSoto when Johnny was out
because of the hit
and run. I have a hard time imagining Brice and
Gage working together, let alone planning something
two are like a cat and its prey."
Click the MRI cardiac image|
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