"Yeah... yeah..." Butler panted. "I won't stop until you.....say so. This is.....fine."|
doing well so far." he told her about the C.P.R.
Gage flipped open the lid of the white Datascope
defibrillator and drew out the
handgrip electrodes for a quick paddle read off of the man's bare skin.
course V-fib." he told Roy, who was rapidly setting up an E.T. tube and the biophone.
"Charging to 400 watts!" Gage reported, hitting the red charge button. He gelled up
and replaced them onto Roush's chest around where Sara's hands were
pumping. "On three, get away
from him. All right? We're going to shock him with
"Okay." Butler nodded, her sandy
hair getting into her face. She blew most of it
away from her sweaty face with a clever pursed lip
puff, as she worked.
"That's very good C.P.R., by the way." Gage shared, impressed.
a girl scout leader. Got some skills." she smirked for an instant. Then her
Gage looked down at the Datascope screen's power readout. "1, 2, 3,... "
leaned back on her knees, lifting her hands up into the air and out of the way.
"Clear!" shouted Roy.
Roush's body convulsed with Gage's delivered shock.
Without prompting, Sara Butler started in again on C.P.R. as soon
as the man's body had settled
into stillness from the electrical convulsion.
"Nothing... No recapture." said Gage listening
with a stethoscope. "Miss?
A break for you. Take his head. Vince, can you switch with her?"
Sara didn't waste a moment, trading places with a deft scramble. She properly
Everett a breath of oxygen through the mask after snatching the apparatus
away from Vince's
Roy's eyebrows rose in surprise at her. "You learned that fast."
"I was watching
him." she said of Vince, leaning forward to rest a bit on her elbows
while she delivered breaths,
one every five seconds. "This doesn't feel any different
than a beer pour spout." she joked. "Same
d*mned button." she shrugged, highly
worried about the sick man.
The manager started laughing
through his nerves. "You've got our best girl, boys.
In all things. She handles most of our emergencies,
using that real cool head of hers."
Gage grabbed a held out biophone receiver from Roy, to begin
their hail. "Rampart,
this is Squad 51. How do you read? " He hit the charge button a second time.
Roy got out a laryngoscope and set up positive pressure suction. He left the unpeeled
lying across Roush's stomach in preparation for the order. Roy looked at the bar
keep and at the
dinner crowd peppering the lounge who were all watching them with
hushed whispers. "Did anybody
hear him complain about being sick today? Headaches?
"Nope." came the bartender's
reply. "There was nothing oddball until he dropped."
"How old is he?" asked DeSoto.
I've carded him for years." replied their helping waitress. At Johnny's double take,
"I.. like to make older patrons laugh." replied Sara. "No harm in that."
"What's your name again?"
Gage half smiled. "Uh, just for communications sake, miss."
The waitress didn't answer, rightfully
"1,.....2.....3.....400!" said Roy in a firm readout to Gage, purposely interrupting
He quickly took the paddles from his distracted partner's hands and used them.
Johnny answered. Again, Everett was defibrillated. This time, the monitor
settled into an ominous,
wavery unresponsive flatline, despite the best CPR delivery
possible being offered by the very experienced
Gage finally got a start reply from what was a very busy hospital. ##Go ahead, 51.##
Early's ready prompt over the background noise of several simultaneous paramedic
calls being handled
by Morton and Brackett, behind him.
"Rampart, we've a 68 year old, non-obese male. Down from
cardiac arrest. CPR was offered immediately by wait staff. We've defibrillated
two. No recapture. Now showing a fine asystole despite CPR and 100%
O2.." Johnny reported.
51. Attempt an I.V. of Lactated Ringer's. Intubate with an endotracheal tube
and administer two milligrams
1/10,000 epinephrine by E.T. Then defibrillate again.
Send me a strip.##
Gage complied. "Establish
a line of L.R... E.T. deliver 2 mg's epinephrine through
a pulmonary route and follow with a third
stacked countershock. 10-4."
Roy worked quickly and got the airway in. He told Sara how to tie
it off with
gauze ribbon so it wouldn't move up or down while in between Everett's teeth.
does it say at the tick marks on the tube. Right where he's biting?" DeSoto
asked her while he suctioned
out some saliva from the man's mouth with a wand.
"15 centimeters." Butler replied, bending low.
"Write it down." Roy told her.
"Got it." Sara said, writing the number in pen onto a table
cloth near her
"Now keep breathing for him, just like you've been doing on the valve,
to just a slight
chest rise for each time. Tell Johnny that measurement when he asks for it." DeSoto
told her, drawing up epinephrine into a syringe. "It'll help Respiratory manage this
The powerful stimulant was added and one bigger positive pressure
vent was used to
deliver the medication deep into the man's bronchial passages.
"Got my line,
too." Johnny told Roy, hitting the charger on the defib unit
with the high flowing I.V. bag hanging
from his teeth. "This is times three. 1....2..."
he counted off, his voice steadily keeping track
of passing time."...3....400 watt
"Everybody clear!" shouted Roy, and they instantly
were. Roush's body lifted
up at the shock with even less muscular reaction than before, with hardly
twitching response to the electricity coursing through his body.
Vince and Butler started
in once again on their solidly working CPR while Roy
turned on the cardiac telemetry that he had patched
and wired into the biophone
to send to Rampart.
Joe Early's response came fast.
the change, 51. Administer 1.5 mg/kg Lidocaine intravenously, 51.
Repeat every 3-5 minutes until
a total of 3 mg/kg has been given. Also
Bretylium 5 mg/kg I.V.# said Joe, reading the monitor. ##
Counter shock one
more time. If we don't get an independent rhythm, give another 2 mg.'s
by E.T. and follow it with a 20 mg. normal saline fluid bolus. Give
one amp sodium bicarb I.V.. He's
in heavy acidosis.....##
DeSoto anticipated. "I'll get a stokes. Let's not wait for the ambulance
worm their way into the building through this dinner crowd." He passed over
medications to Johnny and ran for the door.
"Here, hold this." Johnny told the dining room manager,
passing off the I.V. bag.
Gage parroted their medical orders into the phone. "10-4, Rampart. 2 mg.'s
endotracheally with a bolus flush of normal saline. One amp bicarb I.V push. Stand
our fourth countershock." said Johnny.