From: Jeff Seltun <email@example.com>
Thu, 20 Apr 2006 16:41:51 -0700 (PDT)
Subject: Chaos Night..
Rampart was anything but
quiet. Dixie was fielding
five ambulance patients as they poured in the red
flashing light filled
entrance. "How many more?"
she asked the latest set of attendants bearing in yet
another bus accident
Sam, a cauliflower eared veteran, sighed and shrugged.
McCall grumbled under her
breath. "Ok,. uh. Let me take
a look at them all again before I start giving out
Dixie blinked when she realized that all of them were
broken legs. "Front end crash?"
she guessed, mumbling
to herself. Then she ran plans off out loud as she awaited
the two doctors
she requested by emergency page.
"He can wait, she can wait, she can wait.. Ah, tib/fib?
"Right here in the hallway, Miss McCall?" asked one of
Station 10's paramedics.
"Yep. We're triaging here since you didn't have time to
there." she told him. "Keep your
victim's I.V. TKO. His
EKG's looking good." Dixie looked up. "Who's got
the short of breath?"
Station 99's medics raised their active rain wrapped HTs.
"Us. We do."
"Ok, you first. Into
Treatment Four. I've got a defib set up
and an intubation tray. Dr. Early will be right with you."
"Dixie? What do you have?" shouted Kel, jogging out of
an opening elevator.
"Bus crash. Transfers from Mount Sinai Hospital. They're
at capacity. I've got four lower leg fractures,
possible cardiac slated for Joe in Four." Dixie told him,
handing off her phone notes that
still had wet ink from all
of her scribbling. It had been only four minutes since she
word that her department would be receiving the
The waiting teams of paramedics were patient, keeping up|
on their vitals sets as the two organized
"Ok..." said Brackett. Then he looked up. "Joe. There's an
SOB in Four."
"He conscious?" asked Early, hurrying out of the cafeteria
annex corridor near them, where he had
been eating a very
"No.." said Dixie and one of 99's medics at the same time.
"All right. Where's his run sheet?" asked Joe.
"Under his pillow." said the second paramedic
through the door
he had been holding ajar in anticipation of Joe's arrival.
"Ok, get it out
for me, wouldya boys?" Joe smiled.
"Thanks, Joe. Sorry about dinner.." shouted Kel as he
the run sheets on two of Dixie's wall parked
"No problem. Guess it's time
to start earning my pay." said
The white haired doctor disappeared into the red priority
Brackett looked at the trauma on the legs of two, seeing blood
stains under their sheets.
"Surgery for these." he pointed. "I've
got surgeons on standby up in the suites. The head OR
intercept you. She goes by the name of Carol Evans."
"Evans? Right.." said a newer paramedic from
Dixie couldn't help but smile as she remembered all over again
that her good friend
and ex-second in command of the ER had
been promoted upstairs only last month. "And I wish her all
the luck.." McCall whispered warmly under her breath.
"You said something?" Brackett asked as
he listened to some
fast breath sounds on his remaining two patients.
"Nothing critical. You
want these two in Three? It's clear. I just had
the headache case moved to the floor." Dixie told
"Yeah, you read my mind. That room's closest to the portable X-ray."
Dr. Brackett said.
"Is Mike on the way?"
"Yeah,.. He said he's hitting some traffic.." said Dixie.
as he checked the pedal pulses and Babinski's on
the two waiting to transfer into the room. "Wouldn't
ironic if he's driving by the scene of this very same accident?"
"I'm trying not to
think about it." McCall said. "Uh, oh." she said,
glancing up at another flash of red lights as they
pulled up at
the ER entrance and killed their sirens. She saw two very, very
paramedics get out of a Mayfair in a hurry, carrying
two large bore I.V.s. "What's 110's doing here?
I heard Mercy copy
their call." she grumbled.
Sharon Walters apologized. "Sorry, Dix. Mercy's
just declared an
all full status. I was going to tell you but..." said the dark doe eyed,
blue smocked young nurse intercepting the new team at the doors.
"Oh, terrific.." Kel said. "Dix,
"Yep." said McCall, giving the order for the two remaining leg cases
to go into
Treatment Three. "Gimme your orders you wrote down. I'll
have the labs started ahead of time on these
two for you."
Dr. Brackett went running for the new arriving patient, who was
dark with ash
and being bagged. "Is he a burn case?" he asked
the two paramedics.
"No. Smoke inhalation."
said one of the paramedics. "He was
converted from full arrest four minutes ago."
get a tube down?"
"Didn't have time. He was a load and go right now. Orders from
Chief. We were lucky enough just to get these I.V.'s in,
doc." said the gasping exhausted, smoke stained
"How big was your fire?"
"It's a crack house. Single story. This guy's got
a friend still
coming. He was a little out of touch with reality due to better living
chemistry but he was conscious and stable." said 110's
Brackett sighed, painfully
aware of a growing problem with
Rampart's own available remaining bedspaces.
"Ok, take him into
One. I'll join you. Sharon.. have respiratory
therapy called to bring down a respirator for him. Looks
I'll have to intubate him myself." said Brackett. "Then call
the administrators and let them
know about our own rapidly
diminishing patient bed capacity. Get an exact count of how
have left and let me know directly!"
"Yes, doctor." Walters said swiftly as she held the door
open for the fire case and Dr. Brackett both.
The hospital staff began to hasten around Dr. Brackett, |
settling into a new mode of activity without
having to be
Automatically, L.A. County Fire Department's air fleet was
of a possible re-routing relay operation, from Rampart's
parking lot, for the moment the hospital
was declared full.
The only other option after that was flights out of the city into
suburbs to all of the Level Two trauma centers.
"Let's hope it doesn't come to that." Dr. Brackett
all the fire departments in the area will have to take on those
extra long transports
themselves untilizing the private ambulance
Kel Brackett shouted the moment the
doors closed shut on all of
his room's staff and his fire case. He had glanced at the EKG monitor
Walters just hooked up. "Boys, stick around a minute." he told
Squad 110. "I'm seeing--"
"Doctor.. he's in full arrest.." said Sharon, handing the paddles
over to Kel.
The two paramedics
took over the man's ambu bag and chest
Dr. Brackett gelled his paddles and drove
down the first shock
to the man's clammy skin. ::Dixie. I hope you're faring with your
than I am right now. My batting average is awful.::
thought the sweating doctor.
Dixie had her hands full in Treatment Three. One of her leg cases'
morphine dose had worn
off and it was taking everything she and
two orderlies had to keep the large man on the bed. She told
passing nursing assistant, who had run into the room at the commotion,
to call security for extra
McCall looked up, with an angry thought, even as her voice began
a calm, placating reassurance
she hoped would relax the man.
::Doctor Morton. Where the h*ll are you?:: she demanded privately.
Doctor Morton hit the ER entrance doors at a dead run, slamming
his palm into the emergency release
switch to make the doors fly
open faster. "All right. Where's the worst?"
Five sets of fingers
pointed down the hallway. Mike skidded to a halt,
his Levi jacket still on, and it was then he saw
the retreating backs
of two security guards rushing into Treatment Three. He followed
"Doctor!" yelled Dixie. "This guy has bilateral leg fractures.
He's not combative.
Only in pain."
"I got him!" said Morton, drawing up a fast injection of MS into
"His I.V.'s gone..." Dixie said, holding the man's fighting head.
"Then we'll have to do this
the hard way.."
"Yeah.. Hold him down people.. Tightly. Dixie, cut away his pants."
McCall did so as the man grunted and screamed and tried to throw
off both of his splints.
Morton delivered the narcotic, double dose into the man's hip, and
rubbed it. And then he helped
the four men hang onto the man while
they all waited for the medication to take effect. "How's victim
one?" Mike gasped, looking over his left shoulder at the other
gurney in the room.
"Stable.." said Dixie, backing away to recheck that person's|
vitals status. "She doesn't have spiral
fractures like he does."
"Just how many new people did we get in the last fifteen minutes?"
asked sarcastically, getting concerned despite his frustration.
Dixie sighed, trying to catch
her breath. "Five from a bus crash.
One from a house fire. Who knows how many more we'll be getting.
Mercy's full and so's Mount Sinai."
Morton whistled under his breath. "Helicopters on standby?"
"Yes. The fire department's been notified." McCall answered.
"Where's Joe and Kel?"
with a possible cardiac in Four. Don't know where Kel
is. Last I saw, he was working over 110's redirected
in the hallway." Dixie replied.
"Ok, first things first. This guy's gotta settle down.
ahead and strap him down. I'm authorizing restraints for his
own safety." ordered Morton
to the orderlies and the security
They did so. A minute later, the man sighed and passed
and Dixie automatically opened his airway and slapped on an
oxygen mask. "How much did you
give him?" she asked with
"Fifteen milligrams." Morton grinned openly.
let out a surprised look of admiration and shook her head
"He's a big boy..." said
Morton. "Milt, go ahead and put in his
oral airway. Take his vital signs and give me what you got."
Then he dismissed the security pair. "Thanks. We'll call you
for the next one." he told them bruskily
as he got to closer
work on his two patients.
The two guards departed, adjusting their uniforms
combing their hair back into place before exiting the room.
was quiet by comparison.
The gang was....
From: Patti or Jeff or Cassidy <firstname.lastname@example.org>
Date: Fri Apr 21, 2006 1:28
Subject: Sweet Tooth.
....just finishing up with the dinner dishes. Stoker and Kelly
long since disappeared into the bowels of the locker
room, where they had set up handyman's tools
all things, a sewing machine.
Johnny could hear it echoing clearly around the ceiling
the large bay surrounding the fire vehicles. And his curiosity
was nearly getting the best of
him...for the second time.
Roy noticed his discomforture. "Oh, now don't go starting
again. Cap'll eat you for a snack for sure."
Gage abandoned his soggy dish towel and snagged another
dry, crisply folded one from the utensil drawer to replace it
while he dried the last pot. "Can a
guy help it if he's curious
about just what the heck his friends are working on? Aren't
to find out just what kind of contraption is so good
that it makes a full Battalion Chief order up
a new fundraiser
event, our Water Day, just to finance it?"
"No." said Roy, blandly, pulling
the rubber stopper out of the
sink. The water there started gurgling with a noisy suck down
drain. "We're finished here. How about some ice cream
"Here. Here." said all the
rest of the gang appreciatively.
Even Bonnie barked from her place on one of the bright yellow
orange varnished kitchen chairs.
"Ok, I'll dish them up." said Roy, smiling. He pointedly ignored
his partner's growing restlessness about the preverbial project
carrot, dangling just out of sight
of his nose, in the other room.
"Cap? Chocolate or vanilla?" DeSoto asked, looking up.
need to ask? What color is my coffee in the morning?" he
both Roy and Gage at the same time.
Marco, working on a crossword puzzle nearby, started chuckling.|
"Shows how observant you two are."
he teased. "Roy, he wants
chocolate. Cold enough to stand a spoon in it. Just like the java he
into his mug and always leaves in the freezer for a few minutes
before he drinks it."
made a face. "Eeoow. Cap... Iced coffee?" he shivered.
Roy opened the freezer, found Cap's chilling
coffee pour about which
they had all been pondering, and handed it to him. "Sure, best thing since
Sunday morning breakfast sometimes. Especially in the summer.
Would you be drinking hot coffee with
a sunburn as bad as Cap's?"
he whispered on the side to his partner, pointing even as Hank
an itch gingerly on a still painful ear.
"Uh,... NoooOO." Johnny said, his voice moving up a scale.
think I'd rather prefer lemonade, heh, heh." he said, rubbing a few
on his water drop dotted uniform shirt to polish them.
"We don't have any." said Roy, tightening
his lips into a scowl.
"And quit fidgetting. You're making me nervous."
Johnny threw up his
hands, stalked over to the couch, scooping
up Bonnie along the way, and he plunked down onto the leather
starting to stroke her cinnamon and black streaked coat agressively,
much to her obvious
delight. "Oh for Pete's sake, guys. Doesn't anybody
even care what Frankenstein-ian invention those
two are crafting up
in the changing room?!" he said to the room at large.
They were all enjoying Johnny's comical
reactions too much to end it so soon.
Roy finally offered
up a tidbit. "Whatever it is," he said, licking
frosty but melting Baskin Robbins off of his fingers.
to take it into Rampart for the next stage of testing tonight. It's
gonna be done by Brackett
himself if he's not tied up." DeSoto
Johnny's hand on Bonnie's back stopped stroking
and the tiny
yorkie yipped in dismay, shoving her nose back under his palm
eagerly to demand a
resumption of attention. "Oh, sorry, girl."
said Gage, guiltily plying in once more. "What's gonna
"Hush, Gage. You'll see it at the end of your next patient
call after you get in
to resupply." Hank said with finality. "Honestly?
Your nosing's getting more annoying than my kids'
nagging at me to
buy them something from the new mall one of these days." said Cap,
his bowl from Roy with a smile. "Thanks, Roy."
"Anytime.." DeSoto whispered, thoroughly enjoying
made predicament. "And yeah, I'll get you some Solarcaine for
your ears then, too."
"Thanks. You read my mind." Cap said appreciatively.
"I'm a good paramedic." Roy told him.
"I would sure hope so." Hank fired back. "Or you wouldn't be working here."
Right then, Stoker
and Kelly walked briskly into the kitchen. "Ah ha!"
said Chet in discovery. "I thought I smelled Cap's
coffee curdling in
the cold. It IS time for dessert. Anything left?"
"Tons." said Roy. "Help
yourselves." he told them.
Chet rubbed his hands together and cleaned them free of what looked
suspiciously like glue to Johnny on a damp dish towel. "I put them both
in the rear squad compartment,
Roy. Inside a spare stokes."
"Ok, I won't forget they're there." replied the sandy haired paramedic,
putting the finishing touches of his own two scoops of both vanilla and
chocolate into his carved
Bark! said Bonnie.
"Oh, yeah.." said Roy, setting the ice cream crusted scoop down onto|
a saucer for Bonnie to enjoy.
The dog was out from under Johnny's hands in an instant.
Chet burst out laughing. "Roy,
that's mean. What if her tongue gets stuck?"
"I rinsed it a little.." DeSoto told him. "What do
you take me for? A sadist?"
"Yes." said Johnny. "The worst kind for not sharing privileged information..."
he hissed through his lips as he jerked a pro-offered ice cream bowl out
of his grinning partner's
Roy didn't rise to the bait. "Patience is a virtue..." he said, holding up a
index finger. "You'll see everything soon enough. And you're
gonna love it." DeSoto promised him.
"Yeah... I do." piped up Marco.
"Not you, too..." Johnny glared in irritation at Lopez.
"They demo'd it for me this afternoon in between kids during a pause
in all the water games. I think
it's a really, really good idea.." Lopez
said, slurping up his ice cream as only a hose jockey could.
Gage glommed onto the hint. "AhhhhHHhh. It's a device of some
kind. Something that a firefighter's
gonna be using eventually." Johnny
smiled brightly, finally thinking himself the cleverest of all
"Duhhh." said Chet. "What else would we have fundraised for in a firehouse?"
the curly haired Irishman sarcastically.
Johnny's face fell into irritated dismay and got even
worse when Cap
laughed hugely out of his newspaper.
It was hours later, and the gang was deep in slumber when
the automatic lights came on, rocketting
them out of bed
and into their attached suspenders and boots.
51. Foam 127. Station
9. Tanker fire. At the intersection of 101 and Riverside. 101
Time out: 0306.##
"What time is it, Cap?" sniffed a sleepy Chet.
"Listen up, you twit.
Sam just said it over the airwaves."
Hank replied, equally fuzzy as both men rushed for the trucks.
"And for that, I should make you enter this one into the log book
for lat-- oww." Cap winced as he
bumped a sunburned shoulder
against the doorframe as he went out after the others.
under his arm as Hank froze in pain. "You shoulda
worn sunscreen like I told ya, Cap!" Chet said gleefully.
"Mother's keeper.." muttered Hank as he yanked open
the Ward's passenger side door.
Station 51 rolled out.|
Soon, they were very near. And Cap had received an update.
He thumbed the truck to truck mic. "Guys..
I've just been told it's
a diesel truck. Overturned. Possibly propane." he advised
##10-4, Cap.## said Johnny through the patch. ::Oo, this'll be a
fast one if we
don't have any serious injuries. Then it's
back deep into slumberland for all of us..:: he thought
Hank's voice boomed out once more on the main channel.
"Don't get out until we're
all sure what we're facing!" he ordered.
As the Ward and Dodge turned onto 101, the gang could
smoke, but no fire up on the Interstate.
::That's odd.:: thought Cap to himself, running
through his options
on how to fight a truck fire when it couldn't be seen so very well
in the night's
utter darkness. ::Huh. It would have to hit lightpoles.::
he sighed. He toggled L.A. "L.A., Engine
##Engine 51, this is L.A.##
"Respond Light Truck 90 to our location. Mile marker....34.
##10-4. 90's ETA is six minutes.##
Hank held up his glove for Stoker to hold
them off a goodly distance
from the roiling black smoke to keep a very healthy and safe breathing
margin. He got out and sniffed the air. "That's not fuel." he told the
others as they gathered around
him, donning full scba. "That's--"
Headquarter's voice burst through their Converta-Com. ## Engine
"L.A., Engine 51." Cap mic'd quickly.
##An L.A.P.D. patrol car's just confirmed that your tanker is carrying |
a single payload. 10,000
gallons of....pancake syrup.##
"Pancake syrup?" Chet asked incredulously.
L.A. went on.##
There's a report of one minor driver injury on the
"10-4, we'll keep an eye out
for the victim. Engine 51 out. Ditch
the air tanks, boys. Don't think scorching carbon's gonna do
much harm to us in the short term." laughed Cap.
"Smells like burning marshmallows.."
said Marco, grabbing some
Cap, was still standing by the LaFrance's cab.
had handed him the HazMat book without asking and
was helping him riffle through it.
caught on, determining their wind direction. "Yeah.
How in the world DO you put out a pancake syrup
Roy shrugged, grabbing out the biophone, oxygen and the
light dressing case. "With
Everybody shared a laugh.
Roy and Johnny soon found their dazed, scuffed truck
A male. And they set to work assessing him while the others
worked to snuffle out the hidden
fire hissing softly under
the smoke rising up from the large, slowly spreading pool of
Soon, the fire was knocked down and Cap cancelled the foam|
truck and second alarm assignment.
The Battalion Chief arrived. "What happened?" McConnikee asked.
Cap couldn't help himself. "Fire."
"Oh?" said Battalion, starting to smile. "This had
better be good."
"Oh, it is." Hank chuckled.
"We've just this guy who's
a little singed, but unharmed."
Soon, the veterans of the hose were
joking about hot maple
syrup and going back home to get containers.
Then, Vince arrived on
scene. He had shown up for traffic control
but had missed a few transmissions. "So, what happened?"
The Chief and Cap looked at each other. "Fire." Hank informed
him cheekily. Then Battalion bent
down and scooped up a fingerful of
the glop and ate it. "Tastes like Mrs. Butterworth's."
"You're kidding." chuckled Vince.|
"Would I be eating anything on the ground like this, mister,
if I was?"
laughed the Chief.
Nearby, Johnny was pumping up a BP cuff on the man they had
down onto the ground for safety's sake. A passing motorist, sliding by the
now declared unhazardous
crash site, hollered out. "Is he gonna die?"
to the working paramedics.
Gage looked up in utter
shock and irritation. "Sure he dies...in
about 80 years..." said the angry paramedic to the annoying
Roy got fed up at another one who was rude enough to open his
mouth while they were
loading up their patient into a Mayfair.
"What happened?" asked the second motorist.
erupted. "Plane crash!" he shouted back.
The driver shot Roy a pissed off look and rolled up his
"Nice.." admired Gage as he buckled in their man.
Of course Vince arrived
belatedly to hush up all the coasting
gawkers with his intimidating bulk.
Before the double
doors of the ambulance were shut firmly by Hank,
Chet shared a gem with everyone. "Hey.. who's up
for some pancakes
for breakfast? That truck smells real good.."
Even the bruised, sticky,
and blanketed trucker laughed.
From: Patti or Jeff or Cassidy <email@example.com>
Date: Sun Apr 23, 2006 2:37 pm
Subject: The Shattering..
Dixie McCall and Doctor
Brackett were in the ER nurse's lounge,
nursing steaming cups of satisying Folgers instead of
fighting, leg bleeding people for once.
"So, did he live?" Dixie asked, smiling with her eyes
while she gave herself a java treatment strictly by inhalation.
Kel was so tired
that he was almost mesmorized by the way
the flourescent lights in the room glowed off the steam curls
wafting around Dixie's eye lashes. "Which one?" he chuckled.
"Mr. 'Bus M.I.' or the street bum on
the curb who suffered a
stroke watching the first guy stagger away from the accident
"Both." McCall amended.
"They'll be fine. The first was just a junctional problem and the
is responding to steroidal and anticlotting measures."
"That's good. All my leg cases are gonna
recover, too. Except
perhaps for mine. I ache all over." she complained, finally taking
sip of her stale coffee.
"Tell you what? We both get off in two hours. Why don't you grab your
swimsuit out of your locker and I'll fire up the hot tub on the deck. Just
Tempting. Do I have to cook?"
"Lord no. Not after a night like tonight. That's what takeout's
Dixie's eyes twinkled. "Deal. But first you and I gotta take care of
more thing before we go. Remember you said you'd--"
The breakroom door opened. It was the dark
eyed Sharon, calmer now
but still with dishevelled hair. "Dixie? Roy and Johnny are here. You
me to let you know when they dropped off their latest patient.."
Kel finally remembered his prior
arrangement. "Oh, that's right.Thanks, Ms.
Walters. We'll get right with them. Do they have a stokes
Sharon looked sideways, thinking for a moment. "Uh,. Sort of." she
"Does what looks like a sheet covered DB count?"
Brackett and Dixie burst out laughing. Kel's mirthful mouth split open|
in amusement and he gleefully
got to his feet to rinse out both his
and Dixie's drained coffee mugs in the tiny sink next to the
machine. "Those two." Brackett smiled. "You think a couple of firemen
embarrassed about wheeling a CPR manikin into the emergency
Sharon frowned. "Now why
would they be doing that?" still holding the door
she had cracked opened.
"Wanna find out?"
Kel asked her.
"Sure. I've got a few minutes. Oh. Uh. Dixie. Carol says hi, and all our treatment
rooms have been cleaned up and are ready for the next wave to show up." Walters
"Shhh." Dixie hissed. "Or you'll curse us with more patients too early. We haven't
had a decent chance
to catch our breaths back yet."
"Sorry.." Sharon apologized while she ducked out of the room to
the two senior staffers where DeSoto and Gage had holed up.
Brackett and Dixie soon followed
her to meet up with 51's paramedics, padding
down the still disarrayed hallway, piled up with extra
supplies and gurneys. The
waiting room, thankfully, was back down to normal density for walk-ins.
and Early were deftly thinning down those numbers as they met their cases as
Kel tapped his watch at them and held up ten fingers. Joe and Mike nodded their
Sharon took them to the vacuum isolation room, now brightly lit with its windowless
Johnny Gage was leaning over the single center bed while he manhandled
of something wrapped around the training manikin's torso.
The disguising sheet was shoved down around
the doll's ankles and Brackett
could see that everything Chet and Stoker had sketched out for him
made and was in order.
"Did you remember the defibrillator battery?" Kel asked Roy.
"Yeah. I got it." replied Roy. "I pulled one out of the recharger we keep in|
chattered, high speed.
"Ok.. I'm truly fascinated. Now what is this invention of Stoker and Kelly's,
guys? Some kind of splint?" Johnny said, pointing to the thick band of white
encircling the Andy's chest. He could see the ends of it feeding
into some kind of gray painted metal
board and mechanism lying under the
rescue doll that stretched from its head to its waistline.
"Not exactly, Johnny." grinned Kel. "Do you remember the old style
thumpers we used to use out in
the field? You two did utilize one the very night
the paramedic program became officially ratified
during that mudslide
mining tunnel incident." he said, plugging the bulky battery into a terminal
at the head.
"Yeah. I remember em." said Gage. "I remember I didn't like them too much
all the damage they did to someone's sternum, all for the sake of automated
circulation. I can still
hear the sound of crunching bones even to this day."
Brackett said nothing for
a moment and pulled out a compression meter
common to an electronic Resusci-Annie and plugged it
into Roy and Johnny's
station manikin, right into the cable port. "Gimme thirty, Johnny. Do the best
CPR you can manage and I'll get a strip of it. I'm gonna show you something."
"Ok." Johnny shrugged,
stepping up onto the gurney rungs. Roy opened the
doll's shirt and Gage started in after getting a
landmark through the new
invented band. "Need ventilations?"
"Nope. Just those." Roy told him.
After a half minute of compressions, Johnny stepped back and waited for
Brackett to show him the
paper strip he had made off the manikin. Feeling
cocky, Gage even folded his arms up with confidence,
be in the green. Every one of them. Stoker was a good teacher."
Brackett said, looking up. "But, did you ever notice this line
on the graph paper?"
Johnny looked. "Well what does that squiggle mean?"
"It's the line for intrathoracic pressure.
And that solid, darker line above it
is the point where passive refilling of a heart starts to occur
on any relaxation
period following a compression cycle. Do you see where your trace's
Johnny squinted. "Yeah.. it's.. it's somewhere around 12 millibars."
"That's right. On averaging.
Now did you know that the passive pressure
inside someone's chest needs to reach 23 millibars in order
any blood return, at all, to the heart during CPR? That's what this solid
yellow line means
on the second graph grid located below the one
you're used to seeing." Brackett told him.
implication struck Johnny like a blow. "What? You mean I wasn't
doing a good enough job with my CPR
"You were according to the standards that we have in place
currently. You did the
required fifty/fifty up and down depth ratios, the
required rate and position with only the usual
a cracked rib or two." Kel said, crossing his arms together thoughtfully,
for his point to sink in.
Roy was already smiling.
Gage looked confused. "But that means--"
"That's right. Your patient was still nonperfused ineffectively despite
you did." Brackett told him.
Johnny's mouth fell open in shock.
Roy leaned forward. "Johnny,
haven't you ever wondered why we only
manage to save two percent of all our witnessed cardiac arrest
cases whenever CPR's used?" he told his numb partner.
"Well, sort of. It was in the back of
my mind. But to tell you the truth, I never
really gave that particular statistic much thought.."
Gage said quietly.
Dr. Brackett frowned in agreement.
"That's because having such a low number's
so incredibly depressing.
No one wants to think about it for very long. But your station fireman and
station's engineer did." Dr. Brackett shared. "That's what this meeting's
all about." he said,
throwing a hand over the bed. "Roy, would you
hook up that thumper next? Don't worry about the band.
effect our readings. Sharon, would you help him set it into place. It'll
be good practice
"Sure doctor." said Miss Walters.
"Ok." said Dr. Brackett. "Now we'll run the
same thirty compressions using
purely mechanical means with the thumper. Ready? Johnny, when it's
done, tell us what's on the strip below the compression depth telemetry."
hit the start switch after setting up adult chest compression depth controls.
Soon, the trace
"What does it say?" Dixie asked with curiosity, swinging away the piston arm
the test interval was over.
Gage sighed, his new dismay apparent. "Hardly better than mine. Somewhere
around 15 millibars pressure."
"Umm hmm." nodded Kel. "And that's only because the machine delivers
compressions with absolutely perfect timing with no hesitations or different delivered depths to the
"Well, how about changing the way we do CPR nowadays to something else?
to two? Instead of five to one? That way maybe intrathoracic
pressure can build back up in the circulatory
system over time." Roy suggested.
"Not enough time's being devoted in studies to examine that
said Brackett sadly. "It may be thirty five years or so before anyone gets
enough with all the poor CPR save counts to actually re-examine
and question the status quo because
the people who matter are continual
suckers for established tradition and methodology. Especially
in the firefighting
and medical fields. There's bound to be tremendous resistance to ANY new
idea when that day does come."
"But that thumper still didn't do good enough.." Sharon whispered,
just as stunned as Johnny as she saw that the readings had
stayed the same dismal pressure as
Johnny's hands on CPR.
"You mean we've been thinking we've been successfully maintaining these
CPR needy people all these years with manual CPR and by automated thumpers
when actually we weren't
doing them a d*mned bit of good?" Dixie rasped in shock.
"There've been no confirmed cases of
a CPR turn around when it was used all by itself
until a defibrillator could also be used to correct
the heart conductivity problem."
Kel answered. "Our CPR attempts do help... But only a little bit."
"I don't understand." said Johnny.
Brackett held up a hand. "What happens to someone's blood
Johnny was quick on that one."Carbon dioxide builds up and oxygen levels
as the body demands more to sustain itself. Breathing picks up and the heart rate
to meet increased need for metabolism."
"Exactly right. Now make that same person cardiac arrested
and lying on
the ground. What's happening now?" Kel challenged.
Johnny, Sharon and Dixie looked
Roy replied. "Nothing. Oxygen isn't being used up because there's
no circulation. Carbon
dioxide isn't building up as fast as it could be
like it does with a person who's still breathing.
Oxygen need at this point
isn't so critical. That's probably why the way we do CPR now seems to get
enough oxygen to the brain to gain at least our current two percent survival
rate with defibrillating
"Precisely. At the moment of arrest, some of that still oxygenated blood
to the brain and then any subsequent movements of a person's
body helps minutely to get that last
fully oxygenated heart's full sized
volume where it belongs. But then, the heart gets emptied on
and the super long pauses we take starting I.V.'s and intubating people
off even that tiny bit of faint circulation to an arrested brain."
"And that's why the two percent.."
Johnny said with stunned realization.
"Yes." said Brackett softly. "Now look at this.." he said,
turning on a button
to a machine box attached to Kelly and Stoker's invented manikin board.
canvas band began to shrink until it just snugged around the chest.
Then it began to regularly compress
and release the whole ribcage; its
top, sides and all, like a hangman tightening a slip noose. Kel
it for the proper rate and for a single thirty compression sample cycle.
tore the paper strip printer out of the Annie reader getting
the third test result. "Oh.. " he peeped.
"It's showing 30 millibars. That's
Sharon blinked and startled into a smile. "You mean the heart hypothetically|
is refilling after every
"Yep." said Brackett. "I was intrigued when Stoker and Kelly came to me
this circumferential band compressing idea, but I honestly didn't know how
well their device would
actually work, until today..." he said. "And quite
frankly. I'm very.....very pleased with what I'm
Gage was stupified. "Wow, what about the force being delivered? Aren't
Andy's ribs getting pulverised right now?" he said, flipping on
the new board's power switch again
to see a repeat demo.
"Nope." said Roy. "Put your hand under the band while it's working like
Johnny looked at him askance. But finally did. "Hey. It doesn't hurt at all.
feels like a snug hug when it's bearing down pressure."
"That's because the band's got a larger
surface area. Not just a tiny
piston's circle or the palms of somebody's hands on a sternum."
Kel. "The lungs are also getting squeezed and released right along
with the heart."
Please refresh page to see animation.
Roy grinned. "So some breathing's also being done by this thing and|
providing a slight bit of adequate
carbon dioxide and oxygen exchange.."
he told his partner.
"Do you realize what we've just
seen here? This band machine's gonna
revolutionize the whole fire department, probably nation wide!"
"I had a notion.." said Kel, his eyes very merry.
"Doc, we gotta test
this out in the field. Roy, does this thing set up pretty
fast?" Gage wanted to know, getting into
"Yeah.. takes about as long as a thumper does." DeSoto replied.
brightened into an excited beaming, but then it fell
into dismay a second later. "Doc, what about
no time for much chest rise here."
Brackett chuckled. "You're forgetting
the lung squeezes. He's already
breathing somewhat. You won't need to ventilate anyone under this
band when it's active much at all. I'm speculating that only a six to eight
times a minute assisted
breath rate'll be needed on pure oxygen."
"We gotta test this some more.. See what it can do on
a real person!"
"I've already made those plans and got permission from the hospital
administration to try out our next step." said Brackett. "Sharon. Go
get one of today's med student
donor specimens from downstairs. I think
they're still in the prep room, waiting for tomorrow's physiology
"The adult male?"
"Or the woman. Makes no difference. Anyone who's the best unchilled
work for our purposes optimally."
"Right away, doctor."
Johnny ansed, pacing the
tiny confidential room, rubbing his lips in barely
contained excitement. "Oh, Roy.. this is ...this
is absolutely astounding. Do you
realize how much money could be generated for the sake of the fire
when folks'll start marketing this thing?!" He immediately checked himself. "Oh,
for the hospital as well....heh." he amended.
"And also for our spreading paramedic program.."
Dixie added in
The few minutes it took for Sharon to procure the cadaver seemed
But then she came.
"Did you put a chux under her?" Dixie asked Sharon.
ma'am. I have fresh sheets, too. And suction if we need it."
hook her up." said Brackett, opening the corpse's lab
hospital gown for her physical shift onto the
invention's working metal
board. It took only a short time for them to fit the new band into place.
Johnny had a thought. "How long has she been dead?"
"About twenty four hours. We'll still receive good data despite of all |
her degraded internal chemistry
changes. We needed someone past the
rigor mortis stage." Brackett nodded. "Ready? Roy, turn on the
and the paper tracer."
Roy did so.
Johnny's eyes bugged out. "Oh, my..she's.."
And he automatically
reached for the body's carotid artery before he stopped himself.
a good color?" grinned Brackett. "I knew she would.."
Dixie actually grabbed a fingernail and
did a capillary refill check.
"I got some?" she asked incredulously.
"Yep." said Roy, checking
the other hand. "And all this lividity's travelling."
DeSoto noticed. "See here on her stomach where
we've touched her?"
"She's getting a pulse also. Down to the wrist." Brackett added, checking
Johnny was stunned utterly speechless. "Oh, boy. We gotta tell someone,
doc. We gotta
tell someone today about this whole thing." he muttered,
falling into a seat next to the body's bed.
"We've got a long way to go before we demonstrate anything, Johnny."
said Brackett. "What
Firemens Stoker and Kelly have done here's a very
novel start but any device based on their idea created
be crazy expensive: a very high price tag per use factor just to gain EMS
few more pink corpses in the field. And that my fine friends, will no doubt
be given a very, very
low priority by any brainchild organizations because
their hands are already full regulating and promoting
our still infant staged
Johnny was unbowed. "How much above the two percent
you think we
might gain with this band device when it DOES get developed by the powers
for those folks who were witnessed arrests and receiving CPR?"
"High. Johnny. High." smiled Brackett.
"I'm guessing around a thirty
percent save rate in conjuction with the usual cardiac arrest protocols."
Roy pushed the next happy thought. "Ok. So it'll take more than just
years to push anything more on this band thing. What are we
all gonna call it when all the talking
sessions DO begin in meetings
a decade or so down the road?"
The room erupted in thoughts.
"Robobeat?" "Heart belt?" "Autopulse?"
suggested Johnny, Dixie and Sharon.
"I don't know."
said Brackett, pleased, turning off the band's cycling motor.
They all watched as the woman's
skin waxed once more into the original
chalk and purpling pallor it had been when they began the
"My guess is that the honor of naming anything will fall to the highest paying
and developer. In any case, Stoker and Kelly will be well compensated
eventually for their role in
making this prototype for the county to see. The
hospital can definitely keep Kelly and Stoker's
machine safe here in storage
until its final stage paperwork can be presented and pushed for the
legislative and marketing levels when the time is ripe."
"Wow.." is all Johnny
could dare himself to say. He was still shaking
in reaction at the profoundness of all of it.
Brackett set a comforting hand on Johnny's shoulder. "Would you|
thank Chet and Michael personally
for me for making two bands
for the machine. This second one we'll have to throw away."
sure doc. Heh. I'll tell them that. And a whole lot more, too.
I didn't know those two had it in them
to do this kind of thing!" he
Roy smiled. "Well, you know what they say
about all the quiet types
and clowners of the world.."
"What do they say?" scowled Johnny,
getting mad that his still
flying high enthusiasm was due to someone else's good idea
"I'll leave that answer up to your infinite and ultimate wisdom,
junior. Come on, let's
help the doctor and nurses return this room
back into working order. We can take Andy back out in
his stokes the
same way we got in." DeSoto sighed.
"Oh, yeah? But then we've got a cake to
get to share with
everybody here and at the station to celebrate. The chief's
gonna freak when
he hears that this invention's actually gonna work."
The two paramedics and
the hospital staffers respectfully packaged
up the donor body for the return trip back to the morgue.
They washed up,
disinfected everything, and went on with their respective work shifts with
light and happy hearts.
The experience in the isolation room had utterly banished all signs of
fatigue and stress in absolutely each and every one of them.
From: "Cory Anda" <firstname.lastname@example.org>
Thu Apr 27, 2006 6:04 pm
Subject: End of Day..
Dr. Brackett sighed two hours later as he
the cool, dark sanctuary of his private office. ::I'm through
for the night. Good
riddance. Let the younger, fresher
doctors play all the be-the-hero roles this morning. Dixie
I are gonna hide.:: he thought with a tired smile.
He was barely settled in his chair with his
feet up with both
burning eyes buried deep beneath his leather jacketed
arm, when the door flung
open to admit a fast retreating Dixie
"Kel! They're after me!" she said, slamming
the door shut and
leaning with all of her weight against it.
Dr. Brackett didn't even move.
"Are you off the clock?"
"Yes. I punched out in the locker room, while begging a cigarette off
of Carol. But hers are all gone."
"Then you're Scot free. You can let go of the knob. The door
locks now. Had it installed yesterday, right after an amorous
druggie tried to get to know me
a little bit better past just
the usual doctor to patient relationship."
Click! snapped the
lock as Dixie turned it. The hurrying footsteps
that had followed her, wandered away finally, a few
"Who were they?" Brackett asked, his voice muffled.
"I'm not gonna tell
you. You'll only get mad. Then you'll go out there
to fix their problem yourself and not get paid
for it." Dixie explained.
Kel sighed unhappily. He was the very picture of fatigue.
one hand snaked into a drawer and pulled out a pack of Menthol
100s for Dixie. He gave them to her
with a tattered book of matches
without even stirring from his comfortable slumped pile in the chair
opening his eyes.
Dixie chuckled low in her chest. "Thanks, Kel. But now that I've got em,
think I'm way too tired to smoke. I just might black out on you if I even try."
And she tossed
them right back into the open desk drawer with a practiced
McCall exactly matched Kel's
sag by sliding into the guest chair,
opposite the desk from him. She slung her legs over the cushy
orange arms as she slipped off her thick, tan, high heeled pumps.
"Ooooh. This feels so good."
she melted, letting her head fall over
the seat's back. She began loosening the straight pins out
bun to release her long, flowing frosted hair out of its constrictive
nurse and doctor let the sweet silence, now filling the room,
stretch between them for long treasured
Then an unintentional thump on the wall from the hallway made Dixie |
jump. McCall flew up, startled,
to her bare stocking feet. "Ahh!" She
immediately winced with a tension headache. "You wouldn't happen
have any morphine in that cigarette drawer, would you? Or a valium?"
she said, sitting down
tightly, still holding her newly throbbing head.
Brackett opened his eyes, pulling his arm down.
"You know the answer
to that one, Dixie. All pharmaceuticals must be regularly stored in the--"
"...in the locked cabinet at Emergency's front desk. Yes, I know. That was
just one hundred percent
pure wishful thinking on my part. I'm trying to trick
my head into believing that I'm actually on
the way home right now." and
she let out a small groan of pain.
Kel got up from his chair,
smiling gently. He padded over to stand
behind her, in his own stocking feet, and he started to massage
knotted up and tensed shoulders and neck. "So, how are you coping
without Carol as your
second in command these days?"
"To tell you the truth, Kel, after today, I don't think I can take
it any more."
she whimpered without any tears. "Our two mutual triage incidents today
to show just how much I've relied on her all of these years to
help me out, in running the place.
I just didn't realize how much I really
needed her, until she was gone." Dixie said grumpily.
Kel chuckled softly. "Do you think Sharon's gonna be the right candidate to
fill her shoes? She's
come a long way from being that awkward, giggling candy
striper, who always tripped over herself
whenever things got a little busy."
"She's the one." Dixie sighed. "Of that I have no doubt."
"Oh? What made you finally come to that conclusion?"
"Because I see in her exactly the way
I used to be." Dixie said, letting Kel
massage away the night's stressful memories. "She's a good
she'll be an even better leader eventually. I think I've just forgotten how
takes to shape a promising protege' for the assistant head nurse spot.
Carol picked it up instantly,
probably because she spent so much time over
in..uh,..in ...Nam. Roy even ....r- remembers seeing
...her." McCall's words grew
slower and slower as actual sleep started threatening to overtake her.
"Dixie?" he smiled. Dr. Brackett lingered a touch on the pulse at Dixie's neck.
"Are you still
here?" he teased.
"Barely.." she whispered, falling completely limp and pliable in both of his
soothing, massaging palms.
Kel kissed the top of her head affectionately. "Believe it or
not, I've got you
calmed down now. You're below seventy." he said, letting her go with a last
squeeze. "So, you wanna just hang out and watch nonexistent cobwebs
grow here at the hospital? Or
are you ready for us to begin our late evening/early
morning time out at the Green Pagoda?"
Now. Please." she said, letting him put her shoes back on. "There's
no debate. Not any more. My nicotine
shot nerves can just go straight to--"
"I promise you fried wantons in fifteen minutes." Kel grinned,
back onto her sore feet as he opened the office door to the loud
of a still very busy waiting room.
"When I get my brain and blood sugar back, I wanna get excited all over|
again about that resuscitation
device Station 51 cooked up, ok? So start preparing
your skin shivery lecture all over again. I still
can't believe what can and might
happen with that device of theirs soon. But honestly? Your voice's
about all I
have the energy for right now."
"I'll change dinner to egg drop soup and green
tea. That way you won't have to
chew anything." Dr. Brackett promised her as they walked out of the
doors to the parking lot and paced slowly for Kel's dark green sports car.
she sighed, linking her arm into his. "I wanna be soup, too, in
your hot tub."
hon. I had the landlady fire it up ten minutes ago."
"You're such a good friend." Dixie burbled
sleepily, almost weepy with
tiredness. She leaned her head heavily on his arm and let him support
"You're not so bad yourself as one, either. I like fussing over you, Dixie.
learned that by now?" he told her."You always make my
day." he said, opening the passenger door for
her. "No matter how bad
Both of them smiled when they saw that the sun had already
for the new day.
::Thank God, it's Monday.:: McCall thought, buckling in.
:: At last.
Now we can both just collapse, and rest for a good.. lonnggg while.::
Click Charlie the mechanic |
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