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 Integrity Game
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Page Two

Then Roy yelled after Johnny. "Hey Johnny!
What do you got?"

"I got four Code F... This guy's got a ton of broken ribs
on the left side. I'm finding signs of marked flail
chest. And he's having a lot of trouble breathing.
The O2's not helping. Gonna have to stabilize
this first before we move him out. Man, don't these
guys believe in flack vests and helmets?"

"Nah, " Roy said tightly. "They don't want
to wear them because of the extra weight."

"That's gotta change. Oh, man. Look around us. This
is a just a senseless massacre..!" Gage swore.

"I don't make the rules." Roy replied.

"No, you just support the industry by
condoning them with bets on the horses
instead." Johnny snapped as he carefully
had some track crew help him roll the
moaning injured jockey onto his bad side
once he had been immobilized.

Roy tactfully didn't say anything.

The motion drove the wounded man awake and
he began to swear a stream of words that
weren't in understandable english. Marco
calmed him in animated Spanish getting a quick
history and verbal account of injury from him.

Kelly and Stoker were hard at work with the
hose. Stoker was holding the horse's
head straight out so the heat overwhelmed colt
could breathe while Chet played a powerful stream
of icy water over his head to cool down his brain
pan as rapidly as he could. Soon the horse
began snorting in tight gasps and his legs
began to kick out as he started snapping out
of his unconsciousness.

"Look out!" said a few of the starting gate guys and
they jumped down from the tractors with ropes
to tie around the colts legs so he wouldn't hurt
the firemen trying to help him.

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A gnarled old trainer huffed and puffed his way up
to Chet and he patted him in the shoulder.
"Easy. Ok, keep it up boys, just like that. The
crew's got his legs pinned. Now, play the water
over the rest of him. Get his chest first. Then
everywhere but the legs for that will cause the
tendons to bow permanently if they're cooled
too fast. Don't want him irreversibly lame."

"Sir?" said Stoker, startled at the trainer's
sudden appearance. "Can we do anything
for the other racers down around us? We
have an extra hose."

"Nah. They've cooked too much in the sun.
Ain't nothing gonna wake em now. It's too late.
We can only save this young colt here."

"But.." Kelly started up.

"Just keep working young man.." the wizened
trainer told him. He sighed and got up
from his crouch and wandered over to the dead
stallion in the dirt with the blood filled nose. He
stepped on the horse's flank and pressed down
with a foot, cocking his head when he heard the
telltale gurgle of lungs drowned in an artery
burst. "Oh, Dusty Schraeder. Now you've gone
too far."

Near him, Gage was writing down the vitals he
had obtained on his patient. "Don't tell me.
Skipped Lasix treatment to cut budget corners
with a little insurance money collection on the side?"

The older man in the straw hat looked up
at the dark eyed paramedic who had spoken to him.
"Fraid so. Oldest track scam in the book 'cept for
calcium stunting to cause bone failure." the trainer
said. "You know about horses, young man.."

"I know a bit.." Johnny said. "I have a ranch full of em.
Excuse me.." and he started to relay his medical
information to Cap via his walkie talkie.

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From : Sam Iam <>  
Subject : [EmergencyTheaterLive] Sticky Situations  
Date : Sat, 8 Mar 2003 23:16:01 -0800 (PST)  

Acknowledgements to P. Keiper for providing
an EMT scenario allowing for a believable
slide downhill.

Acknowledgements to Dr. Jeff Seltun on
giving me the doctor speak.

Thank you Sue Hampton ER RN/EMT-D/FF
for the IV type pointers.


"Squad 51 to Engine 51. Uh, Cap, advise L.A.
that we have multiple fatalities here. Numbered four."
Johnny Gage lowered his voice so the kindly trainer
nearest him standing over the dead, bled out racer,
couldn't overhear. "And... ask for a police response.  
I have reason to believe this pileup wasn't an accident."
Then he spoke louder with a heads up glance at Roy
for his history.. "Stand by for vitals on two victims,
Engine 51."

##10-4, Squad 51. .............L.A. has been notified.
Standing by and awaiting vital signs.## Cap replied.

Johnny Gage bent over his agitated victim. "Hey..
senor..Can you hear me? Just try to relax.
Strapping ya on this board's just a precaution. Now
you've got some broken ribs here that we need to
take care of.  Just try to keep from moving around
okay? Having ya on your side like this is gonna
help you breathe better. Marco, keep holding
him just like that. If you have to, get some
of those guys over here to help you."

Marco spoke a few short words in spanish
and two members of the grounds crew
came and knelt by them to help hold the
injured man in position. "Como te llama?"
Lopez asked the injured jockey.

"Jose' Rivero. Aiiyy.." said the man irritatedly.
The jockey continued to swear and cuss in
spanish but his anger wasn't directed at
Gage or Lopez. It was aimed towards a second
trainer who was staying well away from
the dead thoroughbreds. The man was
dispassionately chewing tobacco as he
watched track officials taking photographs
of the dead horses and riders.

The fallen jockey swept off his oxygen mask
and spit in insult as he continued to glare at the dark
dressed man. "Jefe Schraeder! Hablas usted con tu'
ahora. Por que? Mis amigos son muerto!
Por nada!!" cried the wounded racehorse
rider and he once more tried to lift his head up.
"Y mi caballo is infermo sol malo porque de tu!"

Gage held him down firmly by the
shoulders. "Hey, hey.. Now settle down.
That C collar's there for a reason. Stay still. Now
tell me what's wrong? Your breathing's a little off...
Listen to me.. Hey..Where else are you hurting
besides your chest here?"

The jockey ignored Gage until Marco grabbed
him by the face firmly, motioning for him
to look him in the eyes intently.
"Eschuchas!..Nosostros son ayudar. Donde
es su dolor?!"

The jockey tried to pull away from Marco's grasp,
and locked up in agony on the long board, ignoring
both firemen as he continued to rant at Dusty
Schraeder standing just within range of
eyesight. Lopez shook his head in frustration
and glanced up at Johnny. "I told him to listen
to us and that we're trying to help, but he's
not answering me about where else he's

Johnny looked at Marco. "What DID ya
get from him? He's off in his own little
world here. Man, if I didn't know better, I'd
say he's out for vengeance." he said
drawing out his clothes shears from his
hip holster. Gage began to cut away the
stained orange and brown silks from
the man's torso for a closer survey.
"Set that 02 back onto his face again
Marco. He's getting a little cyanotic."

Marco nodded his head moving the
clear plastic mask back over the man's
struggling mouth. "His name is Jose'
Rivero. He is begging his boss for a reason
why his friends died and he's blaming him
for his horse being sun sick like he is."

"That guy over there?" Johnny pointed
to Dusty Schraeder.


Johnny looked up at the black cowboy
hatted Texan and felt an immediate dislike
for the man. ::But he's something for
Vince to worry about when he gets
here.::  His eyes then swept to the colt
Mike Stoker and Chet Kelly were trying
to save with the assistance of the kindly
old trainer.

The colt was now resting on his belly,
quivering like a newborn as he fought the rest of
the way to wakefulness under the flowing
stream of the fire hose. His soaked coffee
bay coat literally steamed in the sun in twisting
curls of sour smelling humidity. A thick
foam began to spread over his whithers
and flanks. Johnny heard the kindly old trainer
murmur that they were succeeding in drawing
the young horse out of heatstroke. "That's it.
Just kidney sweat now.. That's a good sign."

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"Is he going to make it, Mr. Farley?" Chet asked.

The man he had learned was named Walter,
didn't reply and the worried look on Kelly's
face returned in force.

Gage kept his face neutral as thoughts raced
through his head. ::No, that will be up to his
owners. Heat stroke recovery usually takes three
months to half a year. That colt's got good lines.
Hope his share holders make the right choice..::
Johnny thought glancing away from his coworkers.

Gage looked down and swept agile fingers around
Jose's head and down his body, looking for deformities.

He found a small oozing gash on his chest that was
alternately retracting in and burping out as the
angry man respired. The tiny sucking wound was
on the side away from the man's main ribcage injury.
"Marco.. grab an occlusive dressing and tape
it over this wound here. Seal it off only
on three sides. Looks like this laceration's penetrated
through into his chest. He must have fallen on
something sharp when his horse went down."

"Got it.." Lopez said.

Johnny felt along the jockey's sweating chest
thoroughly but found grating, moving bones
only on the flailed side. He snatched for his
stethoscope out of the drug box and
listened to the holed side carefully, then
compared the breath sounds he heard
there to the ones under the rib fractures.
He grunted, making a mental note and
took another set of vitals before finishing
the rest of his survey on the jockey.

He found no further injuries.

Johnny returned to the man's throat
and felt the cooling skin in the area
carefully and over his chest once again.
Then he looked at how the rider's
larnyx sat in relation to the rest of his
neck by sight as he reassessed the man's
consciousness level and checked his

Gage nodded at Roy, who had just
completed his secondary survey of the
unconscious woman rider.

DeSoto had his helpers carry the girl closer
to Johnny and the drug box until both
their victims were side by side, head to head,
nearest all the equipment. Roy crouched over
the EKG monitor case and he opened it. "She's
stable. The 02's keeping her in good color."
he said, handing Johnny his pad of notes.
"Add one more thing. She's got a open fracture
of her left radius and ulna, with sluggish perfusion.
I immobilized her arm in the best position
I could find and she's still got neural responses
and pulses in her hand and fingers but they're
degrading. She may have torn an artery or vein
internally. I'll get your victim patched in for ya
on Lead Two."

"Okay.." Johnny relayed to Captain Stanley
on his hand held radio once more.
"Engine 51. This is HT 51. We're set for a
medical relay to Rampart."

##Go ahead, HT 51.##

Cap Stanley watched as Vince and a detective car
pulled up. He re-established communications on
the biophone that he had perched on a track rail post,
with apprehension. "Rampart, this is Engine 51.
I'll be relaying from Squad 51 in 2. They are still
inaccessible on the horse track and out of effective
biophone communications range."

##10-4, 51. Standing by.## said Dixie.

Once again, Captain Stanley cursed
the whole idea of Santa Anita's turf and dirt race
tracks being set into a bowl just so two lakes could
grace the racing infield's garden grove of Queen's
palm trees.  ::Stupid design. Even if having that
extra water there is a boon for any future fire
call. At least Roy's EKG telemetry will get out.::

Johnny spoke into his HT to Cap.
"Engine 51, Victim One. Male, age
approximately 19 at 105 pounds.
Vitals signs are; Pulse 124, respirations
are 20 and shallow, BP is 90/62. Pupils
are equal and reactive. He's diaphoretic,
conscious, and emotionally agitated. He's
on fifteen liters O2. I've found pardoxical
breathing symptoms with a large flail segment
on his left side. He has a sucking chest wound
to his upper right chest, now occluded. I'm
hearing rales on the left and diminished breath
sounds on the right. Subcutaneous emphysema
is present about the neck and upper chest. He
has been immobilized and positioned flail side down.
His EKG is showing sinus tach. Sending you a strip,
lead two."

Cap relayed the information and soon Joe
Early responded. ##10-4, Engine 51. Tell
Squad 51 to start a large bore IV of Normal
Saline with Lactated Ringers. Run in a 500
cc bolus initially until his BP comes back up again,
then leave it TKO. Have them watch for signs
of further breathing difficulty. I suspect
a pneumothorax. EKG is now showing sinus
tach at a rate of 130. Splint the flail segment
by taping only the effected side until his
breathing improves. Prepare to assist
his ventilations if his resp rate increases over
24 times a minute. Treat for shock. Tell them I
want a new set of vitals every five minutes.##

Cap replied. "10-4, Rampart. Stand by."
and he shared the orders with his two paramedics
still working a quarter of a mile away down on the final
turn. He soon got Roy and Johnny's confirmation
on the orders, and he immediately, received
information about their second victim over his HT.

Cap listened, memorizing details. Then he
called in his men's second medical data set
to Joe Early on the biophone.
"Rampart. Victim number two. A
female approximately 24 years of age.
Weight 102 pounds. Found prone over a rail.
Was conscious, now comatose. Vitals signs are, pulse
90, respirations are 14, BP 100/76. Pupils are
equal and reactive, but sluggish. She's been fully
immobilized and is on fifteen liters 02.
 My paramedic notes probable neck and back
injuries. There's quivering in the upper extremities
and bilateral positive Babinski's finding on
both legs. He earlier reported a growing lack of
sensation on her from lumbar three on down.
There appears to be no palpable spinal deformity.
  Victim has an open fracture of the lower
left arm. Circulation and sensation is
partially compromised despite splinting in
position of alignment."

Cap got his followup on the woman for a
precautionary IV and a rapid transport order.
Inwardly, he hope the girl would get to surgery
in time to save her arm and effect repair to
stop the creeping paralysis she seemed to be

He finished correspondence between his men
and the hospital. Soon, he waved the Mayfair
to the road where he was standing as it
arrived in full siren. "We're gonna load up right
here. The paramedics are bringing in two victims
from out there on longboards.." he told
the attendants running to his side. "The
dirt's too soft for your rig to handle."

The two men nodded and intently watched
the group of people, bearing the two jockeys
in between them all, walking their way.


Cap wasn't surprised to see Detective Crockett
flanking Vince Howard when he had put the biophone
into the awaiting ambulance. "Vince. Detective Crockett.
My man Gage thinks our racing accident wasn't accidental.
I trust his judgement since he's a pretty good horseman
off duty."

"We got any witnesses?" Vince asked.

Cap replied. "Two. But one is unconscious and the other
is in no shape to talk right now. Both jockeys. And I
think Johnny was hinting about learning something
from one of those trainers milling about, too.
Nothing concrete, just a hunch I got from the tone
of his voice."

The tall quiet African American detective thoughtfully
rubbed his chin. "Ok, we'll take it from here, Captain.
Thank you. I'll have a talk with your paramedics once
they're through with their run. Call me once the squad's
back at the station?" he said, heading off the fire
captain's worry that the detective would get in the
way of his men.

"Sure will." Cap said. He took the card the detective
handed him and pocketted it. He started off  
towards Kelly and Mike as they headed back to the
grandstand apron.

Smiling craftily as Cap disappeared around a bend,
Detective Crockett took one look at the deep track
dirt and then once more at his shiny black shoes,
before he unhesitantly stepped ankle deep into the
sandy loam to rendevous with 51's medics on the
far turn.  

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Hank Stanley intercepted Chet and Stoker as
they returned to the paddock side road dragging
their hoses behind them. "I couldn't see what
you were doing. Are they gonna make it?"
he asked about the horses.

"Only one, Cap. Our helping trainer, Walter
Farley, said we got there too late for the others.
Apparently, racehorses cook to death internally
on hot days like this if they take a fall more than
halfway through a race. He said it happens because
their metabolisms are kicked in overdrive."
Kelly said dully.

Cap sighed in sympathy. "Oh, I'm sorry.
I got some good news at least. Two of the
jockeys are still alive.."

"That's great, Cap." Stoker said without enthusiasm.
Come on, Chet. Let's get these hoses packed." and
Hank watched his two disheartened men plod
dejectedly back to the Engine with their load.

Cap called out after them. "Stoker, would you
snag a ride with a track steward cart to go
fetch the squad? You're gonna have to follow
the ambulance with it. Gage and DeSoto really
have their hands full right now."

"Right, Cap." Mike replied and he jogged back the way
he had come, leaving Chet to do the heavy
work. In sympathy, Cap pocketed his HT and
helped Kelly out by climbing onto the hose bed
of the engine to be primary hauler.


"Crockett! I don't have time to talk with
you now.." Gage said distractedly as he
and the grounds crew and paramedic
struggled to carry equipment and victims
to the far rail and the firm concrete apron
beneath the grandstand.

"I just want to ask you a few questions."
The detective said, lifting his feet high and
stumbling a bit in the loam.

"Fine..then help me by taking over.."
he said, snatching the detective's hand and
forcing him to grab the ambu he was
using on Jose'. "Bag him when he
breathes in and also when he doesn't.
Twelve times a minute." he ordered.

"But uh, he's still awake."

"Yeah. I know. Assisting him like this is
helping splint some rib fractures he's got
inside. Marco tells me Jose' says it hurts
like h*ll but he's grateful for the help."

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"Ok. I got it."
Crockett began squeezing the ambu bag
after quickly picking up how Johnny had
been managing. He opened his mouth.
"I know Spanish, too. Maybe I can kill
three birds with one stone by--"

Gage got into Crockett's face. "If you
ask Jose' any question other than, 'How
are you doing?' I'll deck ya.."

Crockett closed his mouth.  
The tall detective nodded dutifully,
outmaneuvered, and just squeezed the bag.

Johnny moved Jose's IV bag from under
the boy's shoulder to his own teeth
to hold as he turned up the dial to wide
open when he saw the young teen pale
another shade of gray. "Let's move

   Click drug box ....    
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 Integrity Game
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