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But Johnny got out a pair of hotpads and got out Chet's breakfast from the oven where it still warmed and began cutting it up for Chet industriously with fork and knife. "Need help eating this?" he asked, not unkindly. "I got it. Just cut the steak into smaller pieces." Kelly said, fumbling with his fork in his abundantly wrapped hands. He stubbornly stabbed an egg onto the fork using his chin and both splinted palms. Marco noticed his difficulty and said, "You're not driving home that way.." "Says who?" "Says me.." Cap said with authority. "Gage has already offered to drive you home. Now do you have someone around to help you about the house until you've healed up in a few days?" "I can call my sister. She owes me one. I took care of her when she busted both legs skiing last winter." "Ouch.." Johnny said, swiping some toast over his rapidly emptying plate. "Did she have fun doing it?" "About as much fun as I had busting my knuckles, and thanks for asking." Kelly said. "Hey, how was I to know? Most people ski for enjoyment's sake." Gage complained. "Yeah? Well, my sister skis like I work out when we both get upset about stuff." "And you both get hurt doing it." Roy said quietly. "Not all the time, DeSoto. Just that one time for her, and now this time, for me.." he said, holding up his splinted palms. "Just make sure your brand of therapy follows less aggressive routes next time Kelly, or there will be h*ll to pay." Cap warned. "I had to talk a blue streak to keep the Chief from disciplining you about your little stunt this morning." Kelly was properly abashed. "Thank you." he said very fast. "Call the Chief when breakfast is over. He wants to talk to you." "But, Cap, I thought you said you got me out of hot water...." "This is about something else, Kelly." Cap toned back. "Oh." "Then get back in here and tell us what it was all about. Sounds important." "Right." Soon, Chet had finished manhandling his food into his stomach and made the call to McConike from Cap's office. Minutes later, he shuffled back into the kitchen, numbly sitting back down into his chair. "Kelly, you ok?" Roy asked. Chet looked up and his face was devoid of humor or pleasure. "Chief says I should start taking a look at the red book from Cap's office pronto like. " "Oh really? Wh-What's the red book?" Gage asked, pretending pretense. Chet didn't say anything. Cap got up and disappeared into the bay. He returned with an unfamiliar fat, red book in his hands. "This book. Chet, The chief probably wants you to know the basics by the time you're back on the duty rosters.. I'm sorry, buddy. I just didn't think the chief would really consider this course of action so soon." Chet read the cover and his face fell with remorse. "Oh, Cap.." he sighed. "I- I can't do this.. It isn't right." Kelly's closed his eyes. "This is the engineer's manual. Seems I've been chosen to be next in line for that position on the engine if Stoker doesn't make it back to the actives list." |
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********************************* From : "patti keiper" <pattik1@hotmail.com> Subject :[EmergencyTheaterLive] The Long Tiny Steps.. Date : Thu, 06 Feb 2003 06:47:31 +0000 Acknowledgements to... Tom Stafford - Firefighter Captain /MD on Chemical Firetruck Training Procedures Acknowledgements to.. Dr. Jeff Seltun for Pulmonary Scalding Lab Test Orders and General Ophthalmology Medicine. Dr. Brackett was paged to Mike Stoker's room around noon. Joe Early was on hand when the call light came on from the observation nurse. Stoker was semi awake and beginning to fight the respirator. Kel leaned over the bed. "Beth, get Dixie in here." Kel ordered. The critical care nurse used the wall phone near Mike's head to summon her. Dr. Brackett leaned close. "Mike. It's ok. You're in the hospital and you've been intubated to counteract the spasming effects of the burns you have in your throat. Try to relax. We'll evaluate you to see if we can let you try to breathe on your own off the respirator." Stoker stopped struggling, but then his hands went to his face. Dixie arrived just in time to help Beth gently restrain him from touching the burned areas on his face around the eye dressings. "He's relaxed about having his eyes covered at least.." she said. Beth piped up, "That's because his station crew mates were up here telling him what to expect when he woke up. Mike, besides Dixie and me, Dr. Brackett and Dr. Early are here." The two nurses quietly spoke to Mike while Kel and Joe consulted after a quick exam of his chest and breath sounds. They stood at the foot of the bed so Mike wouldn't hear them discuss a decision. "What do you think, Kel? Too soon to go off the bird?" Joe asked. "Not necessarily." Dr. Brackett said, rubbing his chin. "The danger of tracheal adhesion is has passed. The initial wheezing we heard when he was admitted has gone away. I think we can go ahead and make him more comfortable. If we run into any problems, we can always bag him until we can re-sedate him for a second intubation." "I agree. Let's go ahead then." "Dix, watch his BP." Joe said and together, the two doctors instructed Mike how to manage himself while the respirator was turned off and the EOA removed. Beth was right there with a hissing suction tube to carry away liquids as the slender airway was taken out. Stoker wanted to cough and he winced from the sting of burns deep inside. He let himself blank out to end the pain. He felt the nurses pull him onto his side to drain out his throat for him and his alarm grew when his diaphragm refused to pull any air into his lungs when he felt the suctioning wand leave his mouth. "BP's dropping. 88/46.." Dix reported. Kel reached for the diazepam syringe pack on the crash cart and tossed it onto the bed so it would be nearby. "Mike." Joe called out. "Give it a few seconds. That winded feeling will ease off. Then see if you can try to inhale on your own. Don't worry. If you can't, we'll support you with 02 on an ambu bag until you're ready to do it on your own." Beth held one ready and flowing on standby. Kel stood listening with a stethoscope as Mike's EKG rate rose higher as the firefighter worked through his fright and the natural cramping of his wounded throat in response to the airway's removal. Finally, after half a minute, Stoker's muscles relaxed and he took in a ragged involuntary breath, tentative, but effective. Immediately Dixie slipped a simple clear, non rebreather mask over his face on full flow sending Beth with the ambu bag valve mask away with a nod. "There."she said. "You did it, Mike. Now relax." Everyone in the room sighed in relief. Mike's tracheal blistering hadn't harmed his ability to breathe at all. The EKG settled fitfully into a normal but fast sinus rhythm that slowed increment by increment with each successful breath Mike drew in. After a minute, Dix announced. "His pressure's back up. Settling in at 120/62." she told the doctors. Dr. Brackett put the sedative med back onto the crash cart and hung his head in relief. |
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Beth placed her hands on either side of Stoker's face so he knew she was near. "Having any pain now anywhere else besides your sore throat and face ?" Stoker shook his head and gurgled when he tried to talk. "Don't." Dix told him. "Not yet. Swallow. Again. Now wait a minute or two before you even think about trying to talk." "The rocky part's over Mike. I promise you no more surprises like that." Kel frowned. Dr. Brackett listened to Mike's chest and upper trachea again with a stethoscope while Joe began to unwrap Mike's eyes bit by bit for a cursory ophthalmic exam. He kept them patched until he nodded at Beth to wave the room lights down to complete darkness except for the pinpoint spot from his ophthalmoscope. The saline soaked patches came away. Stoker's raspy voice whispered to them. "I can't see.." Kel's face softened. "That's because we have the room lights turned off to make it easier on you. You also have some swelling of the tissue around your eyes and both of them have swelled shut. Just relax, Mike. We'll know soon enough what's going on after Joe takes a look at you. Does your chest hurt at all?" "No..." he sighed, still whispering. "Good. Your bronchoscopy didn't show any major damage to your pulmonary tissues. Only some localized scalding above your larynx. The collapsed airway you suffered during the fire reopened again nicely once your coworkers got you back outside away from all the heat." "I stopped breathing?" Mike asked. Joe and Kel hesitated. Then Dr. Brackett ventured into a disclosure. "For a while. Enough to lose a viable heart rate. But there was no difficulty in reconverting you. You were down for only a minute or so and Johnny and Roy got you back effectively enough to matter until you got to the hospital and we could stabilize your vital signs. You ran no hypoxia risks at all." "I almost died?" Stoker asked again. "Almost only counts in horseshoes and hand grenades, Mike Stoker. And you know it." Dixie said. "Now lie still and let the doctors finish examining your eyes." she said no nonsense. Mike stayed hushed. Joe said. "Mike this may hurt a bit when I shine the scope's light into the back of your eyes. I need to see what's happening to the deeper structures there." Stoker gasped when the light shone down. All was a mass of shadows and shocking white flares which smeared together in sparking chaotic afterimages. His head began to fill with pulsing stabs of agony. Mike's EKG sped up suddenly. Joe immediately quelled the light. "What did you see?" Stoker told him. Kel and Joe glanced at each other. Dr. Brackett said. "There may be some fundus involvement here. Perhaps even with the optic disc itself. But then again, those visual anomalies could just be the transitory results of superficial corneal burns. Try it again Joe." Once more, Joe used his scope to peer around Stoker's red swollen eye lids into the eyes below. This time, Mike's discomfort doubled. His hands shot up and gripped Joe's wrist. "Ahh.. don't...!" His sharp movement made Dr. Early drop his instrument onto the pillow. "All right. I'll stop." Joe said quietly. Kel and he and Dix and Beth all exchanged worried looks. Then Joe gripped Mike's hands in firm comfort and he returned them back under the blankets. "Ok, that's enough from us for now. We'll repatch your eyes with more antibiotic salve and try again in a few days." Mike didn't say anything and his heart rate remained fast and panicked. Kel said. "Don't let this dishearten you at all, Mike. Sometimes it takes days or even weeks for normal retinal responses to return to the eyes following heat exposure like this. But from what we did see here, your eyes are intact. Both your scleras are understandably swollen and red and your pupils are adjusting somewhat irregularly due to the burns there, but globally, at this stage, things are looking about as well as we all expected." Mike let the nurses rebind his head tightly, to keep out any more light before he spoke again. "Doctor Brackett. Just how well is 'As well as expected?' " They didn't say anything. Mike filled the silence. "You know, six years ago, Kip Jenkins from Station 16's took a spark on the eye just standing roof watch. And it cost him his job when it later healed over, leaving him with tunnel vision on that side." He swallowed. "Is that going to happen to me?" Kel kept his hand on Mike's arm. "It's too soon to tell, Mr. Stoker. Only time will show us any final outcome here." "I know.. I know..." Stoker said, folding his hands over his chest, trying to pull shreds of dignity about himself as he would a turnout coat against the blazing heat of a fire. "I just don't like being kept in the dark..." Dixie looked down. "Sorry.." Mike apologized for the black feeling joke. |
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Kel said to him. "Mike, let's see how the rest of you is doing in the meantime. Joe, let's order another set of arterial blood gases to see how well it's working out for Mike being off support like this. Also, I want to get a second chest X-ray to compare it to the one we took last night. Dix, I want the lab to get electrolytes, a urinalysis, a BUN, a creatinine series and I want respiratory therapy to get in here to start some pulmonary function tests on Mike's lung performance." "I'll get right on it.." Dix said, moving to the phone. "I'd just wish I could find out answers a little faster. Not knowing anything's killing me.." Stoker sighed, gasping through the oxygen mask. Brackett chuckled in his throat. "Trying being a doctor and compounding that particular problem in the form of fifteen new patients a day. Now you know why doctors like me grumble so much.." he grinned wryly for the nurses benefit. "One step at a time, Mike. It always comes, one step at a time.. For you, that means that all you have to be is a patient patient and the rest will follow naturally. In your future, there may be the slight chance of corneal transplantation surgery. But your positive contrast vision tells me that even that, might not be necessary in the long run." Mike stayed numbly quiet as he attempted to settle his labored breathing around the burns jabbing in his throat. Kel sighed. "Just leave all the worrying to us. It's what we get paid for. See if you can get some rest, all right?" "I'll try, doctor." ------------------------------------------------------- It was four days later on the exercise grounds at the L.A. County firefighting training facility. Station 51's usual fire inspection duty assignments had been traded away to another sister station so she could report with her crew solely for Chet Kelly's benefit. He had passed the paperwork part of the standby engineer's test and now was entering the practical skills testing. A mockup of a two story apartment tower building with a fuel truck spill at its base was the scenario the chiefs had mapped out for Station 51's chemical truck to handle. And on a signal, the whole facsimile was set ablaze along the tarmack using hidden torches embedded from spigots in the concrete. "Ok, Kelly.." encouraged Charlie Atkins, the replacement engineer assigned to 51 until Mike Stoker's situation fell one way or the other over the fence. "This is an easy one. Think...grease. Now, what mix are ya going to pick for your hoses?" Chet Kelly watched Marco, Cap, Roy and John string lines at the ready, aimed at the fire's heart, and they all looked back towards Chet at the chemical panel on the engine for Chet's signal to let go the charged hoses. To one side, the Batallion Chief was also drilling another company as they broke in a new man on driving a ladder truck around an obstacle course. For the moment, the gray haired supervisor's attention wasn't on 51's exercise. Chet Kelly bit his lip, checking and rechecking the pumper readouts. "Repellent surfactant at ....18% per hundred gallons ppm...with every five hundred hydrant gallons from the ground." "Right. Right.. Gotta do that because fuel's so volatile with our 21% air 02 ratio." Charlie said with a nod around the smoke drifting towards them from the building. "Now what else before you release your mixed reservoir to your crewmates?" |
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