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--------------------------------------------------------------------------------------------- "Vicki. Jump! *cough* He's telling us to!" said a blond haired little boy from the high crook of the eucalyptus tree where he and his best friends had taken refuge when the Dona Arana's beach mansion had exploded. Now their safe haven was aflame on top and in the grass below. Barely visible in the rising smoke, Henry the bassett kept on barking at the children far above him. "I'm not jumping!" said the sports jerseyed seven year old girl. "I'll break something." the tiny child sobbed, her face soot streaked. "We gotta do something or the smoke'll get us for sure! *choke* Stevie's asthma's already getting real bad.. Just use the climbing rope. I don't think those firemen on the hill see us yet for all our waving." Henry was enveloped with smoke and he disappeared. But the children still heard him barking. "Where do you think he came from?" Vicki said. "He's barking so mean." "He's not mean. He's angry that we're still staying in the tree with the fire getting closer. I know that sound. That's what Apollo does when I climb up onto the garage roof when I'm not supposed to." said Christopher. "He's ok. He's just trying to tell us to get down from here." Stevie's head drooped a little lower inside the fourth child's arms. Becky shouted to her three other friends. "His medicine's not working any more." the brown haired girl said, " I think it's because of all the smoke blowing up here." Christopher made up his mind and he hung from his arms in mid air until his ankles gripped the rope hanging from their club tree's horizontal branch. "I'm going for help. Becky! Don't let him fall! Vicki, come with me!" "I can't!" the tiny girl wailed. "Yes, you can. I'll just bet this old hound dog'll let you pet him once you get down here. Now come on!" Chris yelled right back. Terrified by the thickening smoke, Vicki scrambled like a monkey after her braver friend. "I'll be right back, Becky. Just keep Stevie warm as you can. Mom says that helps with sick people." Becky wrapped her legs even tighter around the gasping boy's waist where they sat in the crook of the giant tree. Sparks rained down around them, alighting tiny fires on wind whipped limbs at their level. She screamed. |
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"Becky! We're all right! We're almost to the bot--" came Chris's voice from somewhere below under the thick blanket of smoke underneath them. But then the voice choked off as smoke stole his ability to speak and started a fit of desperate coughing. The scared, following Vicki soon fell into the same breathing trouble. "Stevie. Hang on. I got you.." Becky squeaked. "I promise we'll stay up here where the air's good. I won't let you fall." Chris was blinded, he couldn't see. Smoke burned his throat and eyes to the point where he lost all sense of orientation. Then he felt a grip of canine teeth take hold of his ankle. He smiled, gasping. "Vicki we're there! Let go! The hound's got my sock to show us where the ground is." Chris celebrated. A burning branch smacked down from the tree above onto Henry's back and he yelped, letting go of the boy. Chris and Vicki fell to their knees and brushed the smoking embers off Henry's coat, then they began to crawl in the direction he led them, uphill. They struggled to breathe but then they were out of the thick layer of smoke on a slope. Henry began barking in earnest at something up hill. |
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It was a hose team. Chet gladly ordered the others to drop the hose to intercept them, yelling over his radio. "HT 51 to Engine 51. Henry's led two children to my location directly east of the house." he said, pulling off his air mask to offer it to the smallest child who was unable to stand. "Both are suffering severe smoke inhalation." ##10-4. Two pediatric fire victims. Meeting you on the fly!## came Hank's radioed reply. ##Brice and Bellingham are with me.## Another fireman scooped up the older boy as he fainted, making sure that his masked offered air was being taken in with a listening check. "He's still breathing." "Get him outta here then. I got her.." Kelly shouted. He carried her in his arms. Chet bent down to stroke Henry's coat. "Good boy! *cough* You're such a good boy. Come on, Henry. Stick close behind us." and he rose to jog to the street. "We gotta get this little gal to Cap and some O2." his voice trailed off as he ran away from the dog. Henry's happy grin fell. He glanced with a whine behind him. Chet hadn't heard his renewed barking at all. The basset gave a slight cry of pain and indecision before he loped for a second time back into the choking blanket of blue white fire smoke filling the tiny hollow around the big tree. --------------------------------------------------------------------------------------- |
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--------------------------------------------------------------------------------------- Johnny Gage was just handing the senora a very soggy tan Persian cat when Chet and his team fireman burst out of the yard with the two coughing children under their air masks. "Over here!" Brice called out, waving Kelly over, "I'm already set up!" Gage smiled at Marco. "Looks like her ride's gonna wait longer. We've more victims. Call me if she changes." "Right." Marco said to Johnny. Kelly set his little girl in a sitting position leaning against Squad Eight's rear tire. "Craig, she's still clear. Not bubbling at all. But the boy fainted on the way back. I think he took in a little bit more than she did. His words aren't making any sense yet." Brice nodded, handing his partner a second flowing oxygen mask for Christopher even as he gave Vicki her own. "Understood. Bob, would you determine his consciousness level while you deliver this? Thank you, Kelly. Now if you'll excuse us. We've got to contact Rampart base now." and Craig bent to his work over the biophone receiver. Chet rose in relief just as Johnny Gage and Roy DeSoto ran over. "They ok?" Johnny asked. Kelly nodded, testing his air regulator for remaining volume. "They're just fine. Bit of smoke but that's all. If it wasn't for Ol Henry here, we could've had a very different story to tell you." Roy rubbed his nose around his helmet strap. "Henry?" "Yeah, he found the kids and led them to my hose team, isn't that right, Henr--" Chet broke off. "Aw guys, I swear he was right behind me. I even told him to follow us back out to the street." Roy and Gage didn't lose their smiles. "Well, Henry does have a mind of his own. Why don't you go check for him by Cap and the engine? Maybe he's already stretched out on the driver's seat getting praises galore from Stoker and Hank." "Yeah. Maybe you're right. But keep an eye out for him, okay?" and he walked to where the white Ward still gleamed brightly in the sooty sunlight. Five minutes after the kids and the old woman with her tabby shipped out code three with Brice and Bellingham, Johnny and Roy noticed Chet was still frowning. "Kelly? Problem?" Gage asked the quiet fireman. "Yeah. Cap hasn't seen Henry at all since he took off. Not yet anyway." "That's odd." Roy said. "I wonder where he could be?" Johnny rubbed his chin. "Any idea where he might've scented those kids initially?" "I haven't a clue, Johnny. All I know is that he came at us out of a lowish bowl with those two kids hanging on to his hide. He had dragged them out of the worst of the smoke." "He did what?" Roy said incredulously. "That's amazing." "I know. Tell me about it." Chet's head bobbled. Kelly glanced around where Cap was talking with Captain Stone. "Look this fire's practically out. I'm going out back for a bit to take a look around. Maybe he's chasing spooked jack rabbits or something now that all the grass is gone." "I'll let Cap know your 20." Johnny said. "Call me when you spot him. I'll round up all the guys and we'll help you herd him back to the engine. Until then, I think he deserves to enjoy a little fun, don't ya think?" Chet's nod was small and uncertain. Roy noticed. "Look if it makes ya feel any better. I'll circle around from the other side of the house, and I'll meet up with ya, ok?" Kelly didn't say anything and he paced off, still slightly worried. "What's eating him? You didn't have to do that, Roy." Gage said. "Henry's able to take care of himself. And he doesn't need Chet or you fussing over him." "I know that and you know that. But why am I starting to get all nervous here? " Roy stated flatly. "He still hasn't come back despite all of Cap's whistling." Gage's grin faded away into a frown of doubt and concern, "I'll let Cap know the game plan." |
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----------------------------------------------------------------------------------------------- Roy DeSoto saw them before he heard them. His radio's talk button was depressed and over his mouth before he actually knew what he was looking at. "HT 51 to all units. I've spotted two more kids trapped over a smoke pocket in a tree. A hundred meters south of the house." The frequencies from Engine Eight and 51 burst through his channel. ##Their conditions?## came Cap's voice. "One little girl's all right. She's just crying. The boy with her seems unconscious and he's breathing with difficulty." ##What'd'ya need to reach them?## came Gage's question. "Lifeline and belt. Bring the O2. I'm heading down." said Roy. ##A rescue party is headed your way, Roy. Keep in touch.## said Captain Stanley. -------------------------------------------------------------------------------------------- Roy put on his SCBA mask as his head slipped beneath the thick layer of fire smoke and he found the tree by its shadow and relative coolness. His shoulder smacked into it. Groping, he found the rope and headed up in a climb. At the fork in the tree, Roy removed his mask. The wind was blowing fresh air off the ocean to where he and the two children could breathe it in easily. He pulled himself up the last two meters. "Hi. How are you doing? My name's Roy DeSoto and I'm a fireman. Can I look at your friend here?" Becky nodded tearfully. "His name's Stevie." "Can you breathe ok? Sounds like you're coughing a bit there." "I'm ok. The smoke's not bad now. It was worse when that dog first came and found us." "Dog?" Roy asked. "Yeah, that funny hound dog. He made Chris and Vicki leave with him to go find us some help." Becky whimpered. "You said when he first came by..." "Yeah, mister. He started to bark at us again a while ago but he must've gotten tired of doing it. I haven't heard him for a couple of minutes since you showed up." Roy placed that bit of news about Henry's possible whereabouts in the back of his mind for later. He pulled the boy's head into his lap where he straddled the tree trunk's fork. He found a rapid pulse in Stevie's neck and saw retractions when Stevie inhaled, pushing in above his collar bones. "Honey, what's your name?" he asked the sweaty scared little girl. " Your friend's doing ok. My partner and others are coming to help me get you both down from here." "It's B- Becky. Stevie's got asthma real bad. He says all it takes is a little dust to set it off. I guess that's what happened to him. We climbed up here to watch the fire. I thought we were high enough. Christopher said we were." she sobbed. Roy bent close to the boy's nose and mouth and smelled medication. "Did you kids give him a blast using his inhaler?" he said, replacing his air mask over Stevie's pale face. "Yeah, Stevie told me to give him one." "Where is it now?" "It fell down there. That crazy dog found it and tried to hand it back up but he couldn't reach high enough to give it to me." Roy peered straight down and saw nothing but solid gray waist high murk as the fire reacted to being washed down in the nearly extinguished house uphill with billows of steam. The smoke layer rose to caress his ankles. "Johnny! Over here. In the twisted tree down below. It's the only tree top sticking out of the smoke down here." "I see ya. Hang tight! Chet and I and Cap are getting down over there right now. How is he?!" Johnny shouted from his rocky perch in the sunlight, looking into the shadows. "I've got a stokes coming." "His breathing's tight. Asthma attack. But he's moving air. He's gonna need a bronchiodilator a.s.a.p.!" DeSoto shouted back. "He got some earlier but it's starting to wear off." Roy cradled the stridorous boy against his shoulder, leaning the boy's head over it backwards as he monitored Stevie's condition and listened with an ear. "Just keep breathing Stevie. You're all right." DeSoto heard a creaking rope and Johnny Gage's gloves appeared out of the smoke layer. "Gimme him. I got the stokes right here!" Roy handed Stevie down from the tree by the back of his collar. Then he grabbed Becky and carried her down with him to the ground following after. He felt Chet tie a life line to his belt as he kept his eyes closed protectively against the air's sooty sting. Then he was out of the tiny depressed clearing, helping Johnny carry Stevie's stokes up the slope to the road beyond. Cap radio'ed L.A. "L.A., This is Station 51. Respond an ambulance Code Three to our l--" Roy's shout stopped him in mid sentence. "Not enough time, Cap. We can take him in Station Eight's squad as soon as we've stabilized him. We'll be faster that way." "Belay that request, L.A. My paramedics will be taking in a child with breathing trouble directly to Rampart using Eight's rescue squad." ##10-4, 51. Time out 09:32.## |
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Chet was peeling his air mask off, carrying Gage's unused medical gear to put it away, when his foot struck a heavy warm body. It was Henry, lying completely still, covered in dark soot. Kelly got on his radio immediately. "Cap, Gage! On the double! I found Henry! He's down! Bottom of the hill along the stokes line." Chet lifted up a leg and felt the dog's stomach for signs of movement and found only a weak rocking as Henry tried to breathe. Reaching down into the dog's mouth, Chet hooked Henry's tongue clear with a gloved finger until he got it hanging out between his teeth. Henry whimpered, choking on mucous. But then he woke up. "Easy, boy. It's ok, I'm right here." Chet whispered, kneeling by Henry's face. "Stay down, boy. Stay still." he said, holding Henry's singed muzzle. Kelly glanced down and saw Stevie's inhaler next to Henry's shivering front paws. "You found this boy? Good dog. I'll be sure Johnny and Roy get it just as soon as you're squared away yourself." Henry tried to wag his tail. Chet took off his coat and covered up the nearly smoke suffocated station mascot. "It's ok. You're gonna be fine, Henry.." Johnny Gage and Cap pounded down the hill along the climbing rope with the O2 apparatus held between them for leverage. Kelly shouted. "Over here!" Johnny knelt quickly, taking Henry's muzzle between his hands in a precautionary move to protect himself from a bite. "Did he fall?" "I don't think so. Man, he went back for those kids," Chet sobbed, "..and this.." he said, holding out the little boy's tooth indented inhaler. Gage ran careful hands over Henry's coat, looking for liquid. "He's not burned at all. I think that smell is just his hair. Cap, you got him?" "Yeah." Hank said gently, taking over the hold on Henry's head. |
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Kelly said. "He wasn't breathing too well when I got here. Tongue was in the way." Cap nodded. "Johnny.... think we can move him?" "Yeah.. I'm not a vet, but he's not tensing up anywhere with me touching him like this. I think he's ok trauma wise. Sounds like his only problem is the smoke he took in. I think you can let go, Cap." Hank did so, exchanging his hands grip for a valve mask on high flow over Henry's muzzle. He looked up. "Kelly, Roy's ready to transport the boy. Go drive him in." "But Cap.. I wanna stay with H--" "That wasn't a request, Chet. Johnny and I'll handle Henry and the little girl. Now, go.." Cap said, tossing Kelly the medicated inhaler Henry had carried. Chet went. |
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Captain Stone came running down the hill with a short board, passing Kelly going the other way. "I heard. Is he ok?" "He will be if we can get some good air in him and warm him up some." Gage admitted with a grin. "We'll take him to the V-E-T-S once we have that done. Thanks for the doggy stretcher.." he smiled, taking the kendrick board from Stone. The three firemen slid Henry onto the board and strapped him in for the trip up the hill. Cap followed keeping the O2 mask nearby for Henry to use while he slowly woke up. At the top, Becky met them, sitting next to Mike Stoker. "There he is! Our superhero dog! Is he ok?" as they set him on the ground, freed him off the board, and wrapped him up in thermal sheets for insulation. "He'll be just fine, little miss. Although right now, I'm afraid he's got the same problem you do." Johnny said. "You both've more smoke than air in your lungs then what's actually good for ya so before we get to see a doctor and the vets, you both are gonna clean some of that bad stuff out of there, ok.?" "Ok.." agreed Becky, brushing the hair away from her face and the nasal cannula she was wearing. Cap held Henry personally in his lap when Captain Stone volunteered to take over the clean up detail on the house. "Stoker, we'll give them five on this O2 and then we'll take them in with the engine. We'll relay the girl's vitals via radio patch. Marco, get us set to travel." "Right, Cap." ---------------------------------------------------------------------------------- |
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---------------------------------------------------------------------------------- On the trip in, Henry suddenly went limp two minutes away from Rampart. Marco tried to keep the commotion up front in the cab away from Becky's notice as his crewmates hustled to help him. "Are we almost there yet?" she asked Lopez. Marco was watching what Cap and Johnny were doing with Henry so closely, that he almost didn't hear her. "Hmm? Oh. We've a block to go. We'll be pulling up to the ambulance entrance. Can you see that door yet?" he asked the child. Becky plastered her eyes and nose and cannula against the glass, peering out. "Not yet.." Lopez thought. ::Please Henry. Don't be dead. Not yet.:: ----------------------------------------------------------------------------------- Roy was hanging around Dixie's desk when Lopez and Stoker appeared around the corner with a devastated look on their faces. Chet Kelly ran over to them instantly. "How's Henry?" "He's out cold. Happened a minute ago. It's something past the smoke inhalation. Cap's with him now." "Where's Johnny?" Roy asked quietly. "He's with his patient in room three. You know he can't leave a victim until a doc gets there." "Show me. Maybe I can do something.." DeSoto said. Dixie, at her desk, overheard them. She followed the sooty firemen to the emergency entrance doors and out into the driveway beyond. Her heart just about broke when she saw Captain Stanley trying to ventilate the limp basset hound stretched out on an empty gurney with a mask two sizes too big. She snatched up a pediatric sized resuscitation kit from a crash cart and tossed it to Roy. "Roy! I'll make a few phone calls! The doc at the animal shelter still has a link set up tied to our base station." "Through the HT this time? That'll work." DeSoto nodded and he threw his handy talkie on the bed, tearing open the airway adjunct bag as the doors shut between them. The firemen experimented and a baby ambu with hastily wrapped bandage tape around Henry's muzzle created a good enough seal for them to finally pump in oxygen. Henry's gums began to pink up once more. Roy could still feel a pulse in the artery at the point inside Henry's rear thigh. But it was irregular. "What?" he said aloud. "That can't be." he sighed, as it thudded erratically against his thumb. Cap noticed, looking up from Marco who was bagging Henry carefully. "What's the problem?" Kelly looked scared. "What is it?" Roy swallowed, "I think Henry might be having a heart attack." |
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***************************************************************************** From : Champagne Scott <chameleonkate@hotmail.com> Sent : Friday, August 27, 2004 7:09 PM Subject : Fast Times at Rampart Base : The Dog Day Afternoon Dixie McCall made the fastest phone call of her life. And then she glared the fiercest that she had ever glared at the back of Kel Brackett's head. He was just completing an in house phone call with the new resident assigned to the paramedic base station. ::Boy, I sure wish Joe could've been here or I wouldn't have found myself in such a ridiculous bind!:: Dr. Brackett finally rubbed the back of his head in sympathetic heebee jeebies. He turned to find the source of his chills. "Oh, no.." he moaned in warning at Dixie who was already batting her eyes diplomatically. "What are you up to now? I've lunch in five minutes." "Nothing much." Dix demurred. "A single phone call. Just take it. Here." she said passing over the phone to Kel without meeting his eyes. Kel took it as if it were a live rattlesnake. "Kel Brackett, Cardiology." he said into the receiver. ##Doctor Kel Brackett! Land sakes! Am I glad it was YOU that sweet young nurse found milling about the place. Now let's get down to business, shall we?## said the voice on the other end of the phone. Kel buried the red phone line on his shoulder. "Dix who the h*ll is this? His voice sounds familiar, but I can't place him." "That's Barney Coolidge. Don't you remember? Bah-ah-ah-ah-ah-ah-hhhh." she said in a fair imitation of a Pygmy African wild goat. Kel shuddered as the sound sent chills up and down his arms as the memory speared home in recollection. "You didn't.." he warned. "I thought I told you I'd tender a three day suspension on anyone on the staff, including you, who brings the next animal of any kind into my hospital's emergency ward!" Dixie didn't ruffle one iota. "There aren't any animals in here. I didn't break any rules. I followed your stipulations to the letter." |
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"Good." "Henry's not inside, he's outside on a gurney being barely kept alive by ambu." Kel Brackett's face scowled into pure steel and he ground his perfectly white teeth together. Already, the eggs from breakfast decided to sit like stones in his stomach. "Dixie. Now cut it out." She cleared her throat, tapping her foot and calmly indicated the live phone on Kel's neck. Soon, Dr. Brackett's better sense of decorum among peer level colleagues finally won out over letting loose one of his legendary tantrums. "I'll deal with you later.." he promised voicelessly to his conniving head nurse, who hardly fought to keep a smile of triumph off of her face. Kel picked up the chatting phone and said falsely cheerful, "Ah, Doc Coolidge. What can I do for you this fine day?" Dixie smacked him on the arm for interjecting sarcasm. Then she rapidly kicked on the speaker phone to keep Kel at bay with civility as the conversation included any nearby overhearing sets of ears. Dr. Brackett glared again at Dixie but stayed silent verbally when Barney realized that he had the cardiologist's attention back. Coolidge gushed his needs. ##We've got to hurry. Now dogs don't have myocardial infarcts in the same sense that people do. They simply don't live long enough, even with their all meat diets, to build up the necessary placques to cause one. Besides they all have collateral circulation of the coronary arteries..## he bubbled, ##..which allow the clots to "go around" an occlusion that would cause an MI in a human being. No, most likely this basset hound is suffering something congenital brought out by his sudden exposure to that fire smoke. Now what have you found, doctor, vitals wise?## Kel stabbed down the speaker button until it clicked off back into phone mode and he parked it once more onto a muffling shoulder. "Dix, how much haven't you told him? I'm not going to look at that dog now, later, next week, or even next year! I'm a busy man ! And a hungry one who's over five minutes late for his lunch hour." and he turned to leave, forgetting about the phone. Dixie caught the receiver as it slipped off its precarious perch. "Kel, This isn't just a dog in need. This is Roy and Johnny's stationhouse dog. Their beloved mascot. And he just saved the life of that asthma case you just saw in Treatment Two. Along with three other children's lives. Now he deserves a fighting chance! If you won't treat Henry right this instant, I'll find Stan the new resident intern and ask him to take over." She slammed a hand down on the transfer button which sent the connection from the animal shelter onto the HT frequency monitor board. Then she hefted up a handy talkie reserved for mobile communications meaningfully. Kel Brackett stopped her. "I'm the senior physician here! No one is going to tell one of my residents to do anything." he groused. "I forbid you to do it, Nurse." he threatened. Dixie's eyes flamed. "Ok. Shoo! Go on. Leave now for the cafeteria. I dare you. Bon appetit. I hope your meal sits well after you're done cause later you're gonna hear six full grown firefighters bawl like babies when their favorite mascot dies for want of decent medical care a hundred feet away from one of the best cardiologists this hospital has ever seen!" she hissed. Kel's face twitched and his rage immediately simmered to non existence. He growled and snatched away the live radio from Dixie's hand. "Coolidge. Stand by. I'm going to talk to a paramedic who's been with the dog right now." ##Roger that, we're standing by. Both Laura and I.## Barney beamed through the channel. Brackett sighed like a steam engine and bowled over half a dozen slow staff members as he moodily plowed out the emergency entrance doors as fast as his legs could carry him. Roy DeSoto and the other firefighters stood shell shocked and rigid and there was only the sound of the hissing ambu working for Henry evident after Kel's stormy appearance. They all froze, locked eye to eye, in anticipation of Kel Brackett's wrath. The blond paramedic licked dry lips. "Uh, hi doc. I got this Mayfair all set up. Dix thought of i--- Uh... Let's see... I assume any care will fall around pediatric cardiac standards. I got alligator clips for the EKG monitor since pads won't work,..a-a-and plenty of defib gel so a signal can get through Henry's...thick.....coat hair.." he trailed off as Kel Brackett's face twitched again as he took in the expressions of all of Station 51's men who were partially blocking his ambulance entrance with an obscene white fire engine. "Dix.. " he finally sputtered. "This is absolutely.. the last time I ever-" he began. "It sure is.." McCall peeped. "Thanks a bunch." "Here, doc. I got the paddles ready so you can get a quick look for the doc." Roy said. "He's ventilating well, doc. No aspirating." said Hank. "Starting to twitch in his tail even.." piped up Chet. Brackett's voice rose in a level above the babble. "Everybody just... ShhhHHHHH! " Everybody hushed. Except for Marco, who was being Henry's lungs. He kept counting. |
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"Get him inside here. And close the doors before anybody sees us. Roy, in with me. And get Gage in here, too, from that treatment room. Stat." ordered Kel, embarrassed when gawkers saw the patient wasn't a child needing a fast unload from the parked ambulance. "I'll handle that.." said Dixie, dashing back through the automatic doors. As she sidled past, she landed a wet grateful peck on Brackett's nearest cheek in gratitude. "I love you, Kel. Dinner tonight's on me!" she squealed, slamming the ambulance door in his face after she clambered out of the Mayfair. ##Doctor. Speak to me.." commanded Coolidge's voice over the HT. "We haven't much time to play with from what I've heard.## came the disembodied voice from the speaker. "I'm here, Doctor Coolidge. What should I do first?" Kel asked over the radio. Roy stood by with his, as a backup source of information. ##Get me an EKG over the biophone. Now I know it already works, since you got one off little William the goat just fine last year.## said Coolidge. Kel's face twitched again as he remembered his acute embarrassment over the biophone when Johnny Gage had told him who the patient was during that little fiasco. Roy's face flushed crimson. But Doc Coolidge caught none of the theatrics. ##Now from right lateral recumbancy, place the monitor clips on elbows and knees. Put the negative on the right arm, the positive on the left arm and both commons on both legs. Got that?## "Second nature, Coolidge. Same as a small child's." ##Right you are!## Barney said. ##We'll get him squared away yet. Now, send me a strip. I have a few theories as to what's ailing him and I need your help to help me rule em out. Oh, and if he loses that inguinal pulse, have your defibrillator there set to 200 J's at the initial, then go to 300, then 360 stacked if necessary ok? The cardiac meds are the same with lidocaine, epi and atropine. Just use a two year old's dosages in a Ringer's IV.## "Roy, got that?" Kel barked. "Already on it." DeSoto replied. He hefted his talkie. "Doc. Ringer's IV? How much to run in on the onset?" ##Best place for a puncture is the cephalic vein, top of the foreleg halfway up. 200 mls for starters. I don't know if Henry's been pulmonarily challenged.## "His chest is clear." Kel said, listening to the still basset's sooty ribcage. ##Fine. Fine. All the better.##Barney dabbled over the radio. ##Now.. what's your strip showing on your people zapper?## Brackett's eyes rolled up at the reference. But he dutifully applied globs of conductive gel over Henry's shoulder and haunch and set down the paddle rims over his body. "I'm reading some wide or tall P-waves; wide or increased amplitude QRS complexes and a few short-coupled PVC's with frequent ectopics. Hear them?" The monitor gave a fluting bell every time the comatose basset's heart skipped a contraction. ##Umm hm. I'm getting the same thing over here. Doctor Brackett, listen close. I'm trying to narrow down the field of cardiac problem candidates for Henry by being certain there's no chance of these three possibilities: an atrial tumor, that's hemangiosarcoma to you Dr. Brackett, an electrolyte imbalance, such as hypokalemia from breathing so poorly during the fire, or a splenic tumor to get to my original suspicion of arrhythmogenic cardiomyopathy. That's fairly common in middle aged males such as Henry.## "What's that?" Chet said from the ambulance driver peep window. Coolidge heard. ##It refers to a recurrent or persistent arrhythmia in the setting of a normal left ventricular ejection fraction or an irregularity in how Henry's heart pumps oxygenated blood out to the rest of his body.## "Oh, I get it." Marco said as he checked the flow of oxygen to Henry's ambu tubing from the port in the ambulance's wall. Cap was hunched as small as he could be at the foot of the cot where Henry lay. "Want me to take over, Lopez?" |
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"Sure, my hand's cramping." Marco said. Cap and he traded places at Henry's head. Kel and Coolidge were oblivious to anything else around them. Barney leaned into the radio speaker. ##Doctor, have your paramedic begin treatment with a bit of nitroglycerin paste under the tongue. Works wonders without the risks of Lidocaine. Oh, and have him wear some obstetrical gloves administering it or he'll drop into a faint when the medication bottoms out his blood pressure.## "He knows." Kel said grinning. ##Let me know when it's been done. I wanna look at how Henry's EKG responds.## said Barney the shelter vet. Everyone held their breaths as Roy shoved in some nitro paste around a hole in the tape wrapping Henry's muzzle with a cotton swab. Everybody jumped when the rear doors flew open and Johnny Gage climbed into an already crowded Mayfair patient's cab. "How's he doing?" "Got a pulse." "Not breathing." "Ruling out trauma specific cardiac injury." said Roy, Cap and Brackett respectfully. "Ok. Gimme.." he said to Cap, taking over Henry's airway care. Hank sat back down onto his butt, sliding his helmet off onto his lap and he just watched, biting his lip. Kel continued his conference with the shelter vet. "Want a central line in to get a working blood pressure?" ##Nope. Won't help. There's already been some neurohormonal cytokines activation going on because of Henry's myocardial failure and continued limited cardiac output. The EKG's pointing to that.## "I concur. Just wanted to see if your angle agrees with mine." Brackett agreed. "How about initiating some cardioprotection at this stage of the game while we're waiting for that nitro to kick in." |
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##Sounds good to me. Get him armored while he's still ticking. I recommend sotalol as a beta blocker to control Henry's tachyarrythmias. 10- 20 mg by mouth every twelve hours...## said Barney. "But he's still unresponsive.." Kel reasoned over the radio. ##That's no obstacle...## Coolidge's voice bubbled. ##We'll use procainamide, in through his IV, in conjunction with the oral. Have someone inject half a mil for now. Slowly. Titrate it gradually after the sotalol's fully dissolved orally. We're doing so non push, because that beta blocker is a negative inotropic. Don't want to cause Henry to go into sudden death, now do we? He's fought so hard today to make it to nap time.## The firemen around Brackett chuckled. ##Don't be shy about giving Henry some taurine, Dr. Brackett. Its lack can sometimes bring on ACM. Especially in dogs of the couch potato variety as these boys say Henry is.## Coolidge chuckled. "I'm on it." Dr. Brackett grinned, injecting the vitamin into Henry's I.V. line. A minute later, all medications were delivered and the alarming bleeps warning of PVC runs faded away. "I think it's working, doc." Roy said, eyeing the monitor. "Henry's beginning to breathe again on his own. Listen." Brackett did, tapping Henry on the eyelid to see if he blinked. He did, slightly. And then he yawned, craving more 02 as his metabolism sped up. Johnny removed the rest of the encircling tape and left the oxygen tube near Henry's nostrils after he disconnected the ambu bag from it. "Atta boy. Come back to us." he said, rubbing Henry's coat and head briskly. His ministrations rewarded him with a moan of anxiety as Henry muzzily came to. He was aware enough to make a face at the bad tasting medication in his mouth. |
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"He's gonna live!!" crowed Chet Kelly. "All right! I'll radio Station Eight's right now and give em the good news. And I'll tell Stoker to move Ivory off your door step, doc." The peek door between them snapped shut again. The rest of the guys and both doctors celebrated. But Barney didn't for long. He grabbed Brackett's ear once more. ##Now for diagnostics, Dr. Brackett. We're going to need thoracic radiographs for his workup...## "Chest Xrays?" Brackett said warily, knowing that no machine existed inside the Mayfair. ##Umm hmm and a packed cell volume test.## "A CBC.." Kel said in affirmation, using his human terms. ##Yep..and we'll have to get good serum biochemistries to rule out congenital heart failure, thromboembolism or hidden complications in Henry's other internal organs. Oh, and an echocardiogram. I'll have to get an accurate fix on measuring Henry's true LV ejection fraction to map out future impact for a quality of life estimate for your fireboys after today's little misadventure. Least I can do for such a valiant mascot.## "Doctor Coolidge..." ##Oh and we'll need more taurine to add as a nutriceutical into some new low salt food for him. If he's going to be responding with his crew on fire calls regularly, he'll have to get in tip top shape to prevent a repeat of this ACM crisis.## "Doctor Coolidge!" Brackett stated more loudly. ##Yes, my boy?## came Barney's reply. "I'm afraid I'm going to have to draw the line with emergency treatment only here. My board of directors will have a hey day if I do anything more. I could be in serious trouble if any of them finds out I'm even doing what I'm doing now." ##Oh, I wasn't meaning for you to run the tests there..## said Coolidge on the handy talkie. ##You can transport Henry here to me so my staff and I can do it. After all, you're already conveniently inside of an ambulance. That was very clever of your ER nurse to think of doing that ahead of time.## Brackett's ears began to steam. "Doc, I know you skipped your lunch in order to help us out. " said Hank. "Tell you what, you've a very large, very loud, fire engine at your disposal to scatter any traffic out of your way going to the shelter and back again. Please stay and help us with Henry until Coolidge takes over. Deal?" And he held out a sooty, grimy hand. Brackett just stared at it, feeling very outmaneuvered and outnumbered. 'I'm coming along, too." said Dixie from the peek window. "I'm the designated driver of this outfit.." she said, wearing street clothes. "Hang on." and she flipped on the Mayfair's reds. "Oh, no you're not." Kel boomed, immediately apologizing to the dog when Henry sat up in surprise. Henry bolted for Roy's arms while the others struggled to keep him from tangling his I.V. "Oh, yes I am. My shift ended for the day five minutes ago." Dixie McCall stuck her tongue out at her now powerless superior. "So sit down, buckle in and play doctor quietly, Kel. The sooner we leave, the sooner we'll get back." "You aren't authorized to drive a Mayfair!" "Wanna bet? You authorized me as a field training nurse. The state says I can. Hang on.." And they were off under the vanguard of the white engine. Stoker belligerently rendered the street clear before them with a healthy chorus of horn blasts and sirens. ------------------------------------------------------------------------------------------------------- |
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